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<s>[INST] context: Your name made you do it, though unconsciously, suggests new research that finds your name can negatively make you achieve less. Psychologists at Yale and the University of California, San Diego studying the unconscious influence of names say a preference for our own names and initials -- the "name-letter effect" -- can have some negative consequences.
Students whose names begin with C or D get lower grades than those whose names begin with A or B; major league baseball players whose first or last names began with K (the strikeout-signifying letter) are significantly more likely tostrike out.
Assistant professors Leif Nelson of UCSD and Joseph Simmons of Yale have conducted five studies over five years using information from thousands of individuals.
"The conscious process is baseball players want to get a hit and students want to get A's," Nelson says. "So if you get a change in performance consistent with the name-letter effect, it clearly shows there must be some unconscious desire operating in the other direction."
The researchers' work supports a series of studies published since 2002 that have found the "name-letter effect" causes people to make life choices based on names that resemble their own. Those studies by Brett Pelham, an associate professor at SUNY University, have found that people aredisproportionately likely to live in states or cities resembling their names, have careers that resemble their names and even marry those whose surnames begin with the same letter as their own.
The _ , Pelham says, is that he has believed the name-letter effect would apply only to positive outcomes. Nelson and Simmons, he says, are "showing it applies more so to negative things than positive things."
The researchers say the effect is definitely more than coincidence but is small nevertheless. "I know plenty of Chrises and Davids who have done very well in school," Simmons says. [/INST] question: The new research is mainly about the relationship between one's _ . | options: A: name and unconsciousness B: name and characteristics C: name and success D: sports and school achievements | answer: C </s> |
<s>[INST] context: Going to sleep may seem pretty boring compared with all the fun things you do while you are awake. But there's a lot going on in your mind and body while you are sleeping.
Sleep, in fact, is as important to your survival as eating and drinking. Sleep improves your mood, makes you a better athlete, and helps you remember and understand what you learned during the day.
During sleep your temperature drops. Your heart rate slows. Down goes the pressure of the blood moving through your veins. A chemical that controls growth (called a hormone) moves into your bloodstream. Scientists think that sleep brings back energy and improves your immune system. We know what happens while we're asleep because scientists study volunteers who sleep in laboratories. The sleepers are connected with machines that measure brain waves, eye movements and muscle activities.
Sleep is like a school day: it's divided into different periods, or stages. When you are awake, your brain waves fire rapidly. As you begin to relax and drift into the first stage of sleep, your brain produces slower-moving waves and you lose awareness of your surroundings. As you slide to deeper sleep, your body repairs itself from the normal wear and tear of daily life. Then, as you begin to drift back up to a lighter sleep, your mind becomes more alert, and your dreams begin. You are in REM sleep.
REM is the name for the rapid eye movement that happens while you are dreaming. During REM sleep, your eyes move back and forth behind your lids , as though you were watching a movie. During other stages, you might move in bed, but during REM sleep you're still. That's probably because if you could move, your body would act out your dreams. As you get close to morning, you spend more time in REM than in deep sleep, so you dream more. Researchers know that during REM sleep the part of the brain that handles learning and thinking is very active.
Getting too little sleep can affect your personality. Experts recommend that children get at least nine hours sleep a night. [/INST] question: Sleep has many advantages except _ . | options: A: improving your mood B: making you strong C: helping you study D: practising your eyes | answer: A </s> |
<s>[INST] context: During his life Dr James Naismith worked as a doctor, taught P.E and wrote several books. While he never thought it very important, Dr Naismith is today best known for one thing. He was the inventor of basketball.
Dr James Naismith was born in Canada in 1861 and his first job was at a special sports school in the USA.
One day the school principal told James he was having a problem with the students. Because of heavy snow, the students could not go outside. He told James that they needed a sport the boys could play indoors and gave the teacher two weeks to think of something.
It was on the very last day that James came up with his idea. The "birth of basketball" is said to be on December 21, 1891, when two teams from the school played the first game. It was quite different from the basketball games of today. It had 9 players on each team and footballs were used instead of basketballs. Soon after, the game changed to 5 players on each side, using special "basketballs" through nets.
Although Dr Naismith did not live to see basketball become the worldwide game it is today, in 1936, just three years before his death, basketball became an Olympic sport at the games in Berlin. [/INST] question: Which of the following things did Dr James Naismith NOT do? | options: A: Teach P.E in school B: Write some books C: Work at hospital D: Take part in the Olympic Games | answer: D </s> |
<s>[INST] context: Smoking is harmful to our health, but many middle school students are smoking. Their teachers, parents or classmates can't stop them because they smoke anywhere they can't be seen --on the way to school, in the dormitory , or even in the washroom.And most of the students think that smoking is very cool.But I want to tell you my story and then you will see that it's wrong to smoke when you are very young.
When I was a middle school student, my friends at school smoked and they asked me to have a try. So I started smoking when I was fourteen. Soon I couldn't wait to smoke as soon as I was free. After a month I couldn't stop smoking. But two years later, I felt what smoking was doing to me. I couldn't run far, I coughed every morning, and I got very weak. So I wanted to stop smoking. It wasn't easy, but now I have stopped it, and I feel better.
If you smoke, you will get ill more easily, and perhaps you can't grow taller, because there is something bad in cigarettes and also you may get some bad behaviors and habits such as stealing , _ and having a fight with others. So you can see smoking is a bad habit. If you smoke, try to stop. Though it isn't easy, you must do it as soon as possible. [/INST] question: Middle school students may NOT smoke _ . | options: A: on he way to school B: in the dormitory C: in the classroom D: in the washroom | answer: C </s> |
<s>[INST] context: Turns out we aren't good at walking and talking at the same time, according to a study of pedestrians on their cell phones.
Nearly one-third of pedestrians (29.8% ) were distracted by their mobile devices while crossing the street, say researchers of a study published online in the journal Injury Prevention.
Just as drivers who text, talk on cell phones, or adjust MP3 players increase their risk of losing control of their vehicles, pedestrians distracted by their conversations or their devices also put themselves at higher risk of getting into an accident.
During the summer of 2012, scientists in Seattle, Wash. , studied 1,102 pedestrians at 20 crossroads seeing the city * s highest number of pedestrian injuries over the past few years.
They watched how pedestrians crossed the street @ whether they looked both ways or obeyed the crossroad signal @ and also recorded how long it took pedestrians to do so.Distractions included listening to music with headphones, using a cell phone or earpiece to talk on a cell phone, text messaging, and talking with another person.
Overall, researchers found the most common distraction among pedestrians was listening to music (11.2%), followed by text messaging (7.3%), and using a handheld phone(6.2%). But the most absorbing distraction was texting. Compared to pedestrians who were not distracted, those who were texting took 1.87 seconds longer to cross and were four times more likely to not look where they were going, disobey traffic lights, or cross outside of the crosswalk. While the study did not track injuries related to these trends, previous studies have linked such activities to a higher risk of being injured while crossing the street.
Combined with the rise in the use of mobile devices, especially smart phones, the results raise concerns that multi-tasking while walking may be a rising concern for pedestrians. And that danger may only climb, as the number of wireless devices has already _ the population of the United States. Last year, roughly 1,152 people wound up in the emergency room to treat injuries caused by using a cell phone or electronic device, the Consumer Product Safety Commission told the Associated Press in July. Those numbers may be underestimated, however, because patients may not always admit that they were using their phones along with other activities such as walking or driving when they were hurt. [/INST] question: The scientists did their study at the 20 crossroads in order to _ . | options: A: attract more attention B: see more injuries C: record more samples D: find more pedestrians | answer: C </s> |
<s>[INST] context: Something that makes sense is happening in Washington, D.C! Public school kids surrounded by museums and monuments are putting the ready-made learning tools to use -- and actually learning.
A trip to see painter Jacob Lawrence's Migration Series is one of almost 200 trips that Wheelock will organize this year through the nonprofit group Live It Learn It. "For many kids, school is disconnected," says one of four full-time workers and tour leaders. "With the program, they see how what they are learning is connected to their communities."
Seven years ago, Wheelock changed a job as a lawyer for one as a four-grade teacher. When he learned that D.C.'s public schools ranked behind those of other cities in many ways, he knew he had to do something different. He took his class to Capitol Hill for a lesson on the three branches of government -- and saw his students' interest develop quickly.
With seed money from a local couple, Wheelock developed detailed lesson plans for trips to the U.S. Holocaust Memorial Museum, the Lincoln Memorial. The group also has classes for trips to the Anacostia River, boat rides to historical forts. Word spread, and now fourth, fifth, sixth graders from the neediest public schools in the District participate.
"I'm not brave enough to take my class to a museum for over an hour!" says teacher Cathy McCoy, gesturing toward her students. "But look With Live It Learn It, what the kids learn today they'll remember for a lifetime." [/INST] question: Matthew Wheelock once had an occupation as a _ . | options: A: teacher B: printer C: leader D: lawyer | answer: D </s> |
<s>[INST] context: HESSELBACH'S TRIANGLE:-
Boundaries-
1. Medially-Lateral border of rectus abdominis
2. Laterally- inferior epigastric artery.
3. Base - inguinal ligament.
FEMORAL TRIANGLE:-
Triangular depression in front of the upper one-third of the thigh immediately below the inguinal ligament.
BOUNDARIES:-
1. Laterally: medial border of Sartorius.
2. Medially: medial border of adductor longus.
3. Base: inguinal ligament.
4. Apex: directed downwards.formed by the point where the medial and lateral boundaries cross.apex is continuous with the adductor canal.
5. Roof: skin, superficial fascia and deep fascia. Superficial fascia contains superficial inguinal lymph nodes, a femoral branch of the genitofemoral nerve, branches of ilioinguinal nerve, superficial branches of the femoral artery with accompanying veins and the upper part of the great saphenous vein.
6. Floor: medially by adductor longus and pectineus, and laterally by the psoas major and iliacus.
CONTENTS:-
1. Femoral artery and its branches.-
Superficial branches-superficial external pudendal, Superficial epigastric and Superficial circumflex iliac
Deep branches-profunda femoris, muscular branches and deep external pudendal
2. Femoral vein and its tributaries
3. Femoral sheath
4. Femoral nerve
5. Nerve to pectineus
6. Femoral branch of genitofemoral nerve.
7. The lateral cutaneous nerve of thigh.
8. Deep inguinal lymph nodes.
The vein is medial to the artery (base)
Vein posteromedial to the artery (apex) [/INST] question: Inferior epigastric artery forms the boundary of | options: A: Femoral triangle B: Hesselbach’s triangle C: Adductor canal D: Popliteal triangle | answer: B </s> |
<s>[INST] context: A painful vesicular rash in a dermatomal distribution strongly suggests herpes zoster, although other viral pathogens may also cause vesicles. Herpes zoster may involve the eyelid when the first or second branch of the fifth cranial nerve is affected. Prompt treatment with an antiviral such as acyclovir, valacyclovir, or famciclovir shortens symptomatic illness and decreases the chance of post-zoster neuralgia. Impetigo is a cellulitis caused by group A-hemolytic streptococci. It often involves the face and can occur after an abrasion of the skin. Its distribution is not dermatomal, and it rarely causes severe pain. Chickenpox produces vesicles in various stages of development that are diffuse and produce more pruritus than pain. Coxsackievirus can produce a morbilliform vesiculopustular rash, often with a haemorrhagic component and with lesions of the throat, palms, and soles. Herpes simplex virus (HSV) causes lesions of the lip (herpes labialis) but does not spread in a dermatomal pattern. [/INST] question: An 80-year-old female patient complains of a 3-day history of a painful rash extending over the right half of her forehead and down to her right eyelid. There are weeping vesicular lesions on physical examination. Which of the following is the most likely diagnosis? | options: A: Impetigo B: Adult chickenpox C: Herpes zoster D: Coxsackie A virus | answer: C </s> |
<s>[INST] context: On the first day of school, Jack found a little old lady with a warm smile."Hi, handsome. My name is Rose. I'm 87 years old."she said.
"Why are you in university at such a YOUNG age?" Jack asked.
"I'm here to meet a rich husband, get married, have a couple of kids, and then retired and travel." she answered.
Jack knew she's joking but he was surprised what encouraged her to be here at her age.
"I always dreamed of having a university education and now I'm getting one!" she told me. We became friends. Every day they would talk after class. Jack always enjoyed listening to this "time machine" as she shared her wisdom and experience with him. And Rose easily made friends wherever she went.
At the end of the term, Rose was invited to make a little speech. She said, "We don't stop playing because we're old. We grow old because we stop playing. Being happy and achieving success may keep you staying young. If you have a dream, hold on. When you lose your dreams, you die."
"Anybody can grow older. _ doesn't take any talent or ability. The idea is to grow up by always finding the chance in change..." [/INST] question: Rose, an 87-year-old lady, was Jack's _ . | options: A: granny B: classmate C: teacher D: friend | answer: B </s> |
<s>[INST] context: Cows that are named and treated with a "more personal touch" can increase milk production by up to 500 pints a year.
The study, by the university's School of Agriculture, Food and Rural Development, involved 516 farmers across the UK.
The study found farmers who named their cows got a 54% higher production than those that did not give their cows names. Dairy farmer Dennis Gibb said he believed treating every cow as an individual was very important.
"They aren't just our means of making money. They're part of the family," he said. "We love our cows here and every one of them has a name. All of us regard them as 'our ladies' but we know every one of them and each one has her own personality."
Dr Catherine Douglas said, "What our study shows is what many good, caring farmers have long since believed. Our data suggests that UK dairy farmers regard their cows as intelligent beings . They are able to experience a range of emotions ."
"Placing more importance on knowing the individual animals and calling them by name can, at no extra cost to the farmer, also increase milk production."
,. [/INST] question: How much milk can a named cow produce in a year? | options: A: 300 pounds B: 500 pounds C: 500 pints D: 600 pints | answer: C </s> |
<s>[INST] context: Where on Earth are you? Navigators use lines of latitude and lines of longitude to locate places. Lines of latitude run east and west around Earth. On a map or globe, these lines appear as running sideways or horizontally. Lines of longitude run north and south around Earth. These lines go up and down or vertically on a map or globe. These lines create an imaginary graph paper on the Earth. They make it possible to find an absolute, or exact, location on Earth. They even allow us to give an absolute location to a place out in the middle of the ocean.
Lines of latitude tell us how far north or south of the Equator we are. Sailors have used primitive navigation tools, like astrolabes, since ancient times. The astrolabe uses the sun and stars to find an approximate location. Using such tools, they have been able to approximate their distance from the equator. Although their instruments may not have been the high quality we have now, they were incredibly accurate for their time.
Lines of longitude tell us how far east or west of the prime meridian we are. Sailors constantly looked for new ways to increase their navigation skills. Still, it wasn't until the 18th century that they were able to measure degrees of longitude. They would have been very envious of the technology available to us today.
When we use lines of latitude and longitude together, we can get a very precise location. If we want to identify the absolute location of a point, we look where the latitude and longitude lines cross nearest to that point. We use the coordinates for that point as its address. Many maps today include degrees of latitude and longitude. [/INST] question: _ make it possible for people to find an exact place on Earth. | options: A: Latitudes B: Longitudes C: Navigators D: Sailors | answer: C </s> |
<s>[INST] context: In November of 2007, NBC Universal launched its first official Green Week. Throughout the week, NBC Universal presented over 150 hours of environmentally themed content through multiple platforms .
Now, NBC Universal is proud to present Green Week 2012. With a new theme and message of "Green Your Routine", NBC and NBC.com presents green-themed tips in several of our daytime life, among several other features here on the "Green Your Routine" site.
Fashion & Beauty
Throw a clothes exchange party! Are you dying for that sweater your friend wore the other day? Well, maybe she'll trade for that old T-shirt you have. Here's a website that helps you organize an exchange party (www.swapstyle.com), or just plan your own!
Go natural with organic make-up. Applying unnatural products on your skin wasn't exactly that nature intended. Try switching to a line of organic make-up and cosmetics for a different way to bring out your natural beauty.
Home
Drop a brick in your toilet tank! Literally! According to the EPA, flushing makes up 30 percent of a household's water use (about three to six gallons per flush). By placing a brick in your toilet tank, you can help to conserve the amount of water used during each flush.
Work
Print smarter. Printing and copying can be one of the most costly operations in any office. To save on ink and paper costs, print double-sided and try to fit more than one page on a sheet. More printing tips can be found here: lifehacker.com
Turn off your computer. Do you leave your computer on over night? If so, you're using up a good amount of electricity. If you can, try turning off your computer and the power strip it's connected to. If you can't, shut off your monitor at least.
Transportation
Organize a car pool . There are many benefits to carpooling. You save on gas and you get to ride in the HOV lines. Get connected with your neighbors and co-workers to start sharing rides and check out this website for more tips: www.erideshare.com.
Lose the car and get a bike. If you live close to where you work, try taking a bike instead of driving. You'll keep in shape and save on gas!
Every small step and efforts makes a difference! Be sure to GREEN YOUR ROUTINE! [/INST] question: NBC Universal holds Green Week activities _ . | options: A: in a university B: in a park C: in an office D: on the Internet | answer: D </s> |
<s>[INST] context: Can you write down a Chinese word being read to you? Sometimes it can be difficult when you find the word is not included in most dictionaries.
Lu Jialei, 14, from Hangzhou Foreign Language School, won the CCTV Chinese Character Spelling Contest on Oct 18th, 2013. About 160 people competed. The host read a word to the contestant, explained its meaning and gave sample sentences. The contestant was required to write down the word.
Winning the contest was a "surprise" to Lu. "I was not the smartest one," she said. "But I paid attention to details." To prepare for the contest, she and her teammates studied the Modern Chinese Dictionary for 10 days. There are more than 56,000 entries including characters, words and phrases in it. She also had a secret weapon. She studied how Chinese characters were formed.
"When others paid attention to the plot of a story, she looked at how authors use words and sentences to express themselves," said Su Yunsheng, Lu's Chinese teacher. Su is happy to see students like Lu find the beauty of Chinese language.
"Besides using something Chinese and having Chinese traditional festivals, learning to write Chinese characters is also an important part of inheriting Chinese culture," said Su. [/INST] question: Lu Jialei was born in _ . | options: A: 1997 B: 1999 C: 2001 D: 2002 | answer: B </s> |
<s>[INST] context: Look! There are thousands of people waiting to buy tickets home in the railway station. Each time when Spring Festival comes, buying tickets of train trip would be very hard. And things seem to be getting worse and worse, although we have greatly increased the mileage of railway network and speeded up trains. Why? It's because too many people want to go back home to spend Spring Festival with their family. Many people become angry with the Ministry of Railways.
They wonder why it is hopeless for them to get the tickets from the railway station Instead, they sometimes can only buy them from ticket scalpers at much higher price.
The Ministry of Railways estimated that about 188 million passengers would travel by train during the 40-day peak period surrounding the 2009 Spring Festival holiday. The number of travelers will be 8% higher than that of 2008. This problem even drew the President Hu Jintao's attention. He wrote a note to Liu Zhijun,Minister of the Ministry of Railways, asking him to take action to improve passenger convenience. Afterward, officials from the Ministry of Railways said they would try their best not to let any ticket-buyers spend Spring Festival at the railway station. [/INST] question: Many people can't buy the tickets from the railway station, and they sometimes can only buy them from the scalpers _ . | options: A: expensively B: happily C: dangerously D: hardly | answer: A </s> |
<s>[INST] context: Recently hand-foot-mouth disease has spread across China. In the past three months, there have been about 41,846 cases in 30 provinces and regions. The number is increasing. Eighteen Chinese children have died of the disease so far this year.
What causes the disease and why is it dangerous?
Hand-foot-mouth disease is a common childhood illness. It mainly affects children under the age of 10. It gets its name from the rash that develops on the hands and feet. It can also cause blisters in your mouth.
A child who has the disease will usually have a fever, a runny nose and sore throat. He or she doesn't want to eat or drink because of pain in the mouth.
Hand-foot-mouth disease is mostly not serious. The fever and rash clear within a few days. But in some cases, the virus affects the heart, lungs or brain. This puts the child's life in danger.
A virus causes hand-foot-mouth disease. The disease spreads easily where a lot of young children are together, such as in a child-care center. Sometimes it can also affect teenagers and adults.
In order not to pass on the virus, good hygiene is important. We should wash our hands as often as possible. Especially we should wash our hands before meals and after going to the toilet. [/INST] question: More than _ people have caught hand-foot-mouth disease this year. | options: A: thirty thousand B: forty thousand C: four million D: fourteen thousand | answer: B </s> |
<s>[INST] context: A military train carrying soldiers has derailed south of Egypt's capital Cairo, killing at least 19 people and injuring more than 100, officials say.
The train was travelling to an army camp in Cairo when it came off the tracks in the Badrashin area of Giza.
It is not yet known what caused the accident.
Egypt's roads and railways have a poor safety record. Last November 50 children died after a train crash into their school bus.
Both the transport minister and the head of the railway authority were forced to resign as a result of the crash, which took place in November near Manfalut, 350km south of Cairo.
Investigations later showed the barriers at the crossing were not closed because the signal operator had fallen asleep.
Monday's incident occurred as the army train was heading from Upper Egypt into Cairo.
Reports say more than 1,300 passengers were aboard the train when the accident happened shortly after midnight.
The passengers wounded in the accident have been taken to hospitals, the governor of Giza said.
An eyewitness told BBC Arabic that he saw two dozen dead bodies at the scene of the accident.
The latest incident could increase the pressure on the government to deal with the safety of trains, the BBC's Said Shehata reports from Cairo.
Four years ago, some 18 people were killed and dozens injured in an accident crash between two passenger trains in the Giza area.
And in 2002, a train caught fire in Cairo, killing 373 people. [/INST] question: The accident perhaps happened at _ . | options: A: 1 p.m B: 2 p.m C: 6 a.m D: 1 a.m | answer: D </s> |
<s>[INST] context: Have you ever noticed that some people am able to effortlessly remember even the most boring details, and quickly understand new things, and wished that you too could be like that? To unlock the full potential of you brain. you need m keep it active and acute. But how? Check out these tips:
.Exercise&get your body moving
Exercising doesn't just exercise the body; it also helps to exercise your brain. Without regular exercise your blood vessels<<)begin m lose the ability to effectively pump blood and it also mduws the amount of oxygen and nutrients thatyour blood carries to your brain. When the nutrients don't make it them, the brains ability to function is compromised. To prevent this from happening, make sure you get moving every day. Walking, swimming and dancing arc all excellent activities.
Get rid of stressorsbnd seek help for depression
Among the most brain-damaging stressars is severe depression, which is actually often mistaken for a memory problem since one of its primary symptoms is the inability to concentrate. If you can't concentrate, yon might feel like you am conrtantly forgetting things. Depression increases the levels of codisol in your brain, which affects your memory. Seek professional help to get rid of your depressionyour brain will thank you.
.Feed you brain
50 to 60 percent of the brain's overall weight is pure fat, which is used to insulam its billions of nerve cells. The better insulated a cell is, the quicker you will be thinking. This is exactly why paints are advised.feed their young children whole milk. Thus. eating foods chat contain a healthy mix of fats is vital for long-term memory. Some excellent food choices include fish end dark leafy green vegetables. [/INST] question: The real cause of the inability to focus is _ . | options: A: poor memory B: liule exercise C: seious deprrssioa D: uhualthy eating | answer: C </s> |
<s>[INST] context: People diet to look more attractive.Fish diet to avoid being beaten up,thrown out of their social group,and getting eaten as a result.That is the fascinating conclusion of the latest research into fish behavior by a team of Australian scientists.
The research team have discovered that subordinate fish voluntarily diet to avoid challenging their larger competitors."In studying gobies we noticed that only the largest two individuals,a male and female,had breeding rights within the group," explains Marian Wong."All other group members are nonbreeding females,each being 5-10% smaller than its next largest competitor.We wanted to find out how they maintain this precise size separation."
The reason for the size difference was easy to see.Once a subordinate fish grows to within 5-10% of the size of its larger competitor,it causes a fight which usually ends in the smaller goby being driven away from the group.More often than not, _ is then eaten up.
It appeared that the smaller fish were keeping themselves small in order to avoid challenging the boss fish.Whether they did so voluntarily,by restraining how much they ate,was not clear.The research team decided to do an experiment.They tried to fatten up some of the subordinate gobies to see what happened.To their surprise,the gobies simply refused the extra food they were offered,clearly preferring to remain small and avoid fights,over having a feast.
The discovery challenges the traditional scientific view of how boss individuals keep their position in a group.Previously it was thought that large individuals simply used their weight and size to threaten their subordinates and take more of the food for themselves,so keeping their competitors small.
While the habits of gobies may seem a little mysterious,Dr.Wong explains that understanding the relationships between boss and subordinate animals is important to understand how hierarchical societies remain stable.
The research has proved the fact that voluntary dieting is a habit far from exclusive to humans."As yet,we lack a complete understanding of how widespread the voluntary reduction of food intake is in nature," the researchers comment."Data on human dieting suggests that,while humans generally diet to improve health or increase attractiveness,rarely does it improve long-term health and males regularly prefer females that are fatter than the females' own ideal." [/INST] question: When a goby grows to within 5-10% of the size of its larger competitor,it _ . | options: A: leaves the group itself B: has breeding rights C: eats its competitor D: faces danger | answer: D </s> |
<s>[INST] context: Elderly women who eat foods higher in potassium are less likely to have strokes and die than women who eat less potassium-rich foods, according to new research in the American Heart Association. "Previous studies have shown that potassium consumption may lower blood pressure. But whether potassium intake could prevent stroke or death wasn't clear," said Smoller, professor of the department of population health at Albert Einstein College of Medicine, Bronx, NY.
Researchers studied 90,137 women, aged from 50 to 79 for an average 11 years. They looked at how much potassium the women consumed, as well as if they had strokes, including ischemic strokes , or died during the study period. Women in the study were stroke-free at the start and their average dietary potassium intake was 2,611 mg/day. Results of this study are based on potassium from food, not supplements.
The researchers found: Women who ate the most potassium were 12 percent less likely to suffer stroke in general and 16 percent less likely to suffer an ischemic stroke than women who ate the least. Women who ate the most potassium were 10 percent less likely to die than those who ate the least. Among women who did not have high blood pressure, those who ate the most potassium had a 27 percent lower ischemic stroke risk and 21 perc ent reduced risk for all stroke types, compared to women who ate the least potassium in their daily diets. Among women with high blood pressure, those who ate the most potassium had a lower risk of death, but potassium intake did not lower their stroke risk.
"Our findings suggest that women need to eat more p otassium-rich foods. You won't find high potassium in junk food. Some foods rich in potassium include white and sweet potatoes, bananas and white beans."
The U.S. Department of Agriculture recommends that women eat at least 4,700 mg of potassium daily. "Only 2.8 percent of women in our study met or went beyond this level. The World Health Organization's daily potassium recommendation for women is lower, at 3,510 mg or more. Still, only 16.6 percent of women we studied met or went beyond that," said Smoller.
While increasing potassium intake is probably a good idea for most elderly women, there are some people who have too much potassium in their blood, which can be dangerous to the heart. "People should check with their doctor about how much potassium they should eat," she said.
The study was observational and included only elderly women. Researchers also did not take sodium intake into consideration, so the potential importance of a balance between sodium and potassium is not among the findings. Researchers said more studies are needed to determine whether potassium has the same effects on men and younger people. [/INST] question: The benefits of potassium intake to elderly women do not include _ . | options: A: preventing strokes B: reducing heart attacks C: cutting down death risks D: lowering blood pressure | answer: B </s> |
<s>[INST] context: Do you like to listen to music when you feel sad? Do you like to sing songs in the shower? Music is everywhere. But in many countries, music classes in schools are _ .
These days, because of the bad economy in the US, some schools fired arts teachers including music teachers. Some students don't have the chance to learn music. In China, there are no exams for music. So many students choose to make use of their time and study subjects like science, math and history.
But do you know that learning music helps children grow?
"Playing music is like doing different things all together", said Gottfried Schlaug at Harvard Medical School. For example, when playing the piano, people see the music notes. And they decode them. At the same time, they use their fingers to make sounds. You do all these things at the same time.
Scientists say that music helps with science too. Einstein played the violin. And German physicist Max Planck was talented in playing the piano.
Music is also a very valuable thing. It makes you interested in things, and it makes you happy, according to US National Science Foundation. [/INST] question: What instrument could Einstein play? | options: A: piano B: guitar C: violin D: Saxophone | answer: C </s> |
<s>[INST] context: Clinical Triad for Diagnosis of PID Pelvic organ tenderness, Adnexal tenderness, Cervical motion tenderness (Suggests the presence of peritoneal inflammation, which causes pain when the peritoneum is stretched by moving the cervix and causing traction of the adnexa on the pelvic peritoneum) Direct or rebound abdominal tenderness may be present. Evaluation of both vaginal and endocervical secretions is a crucial pa of the workup of a patient with PID. Increased number of polymorphonuclear leukocytes may be detected in a wet mount of the vaginal secretions or in the mucopurulent discharge. More elaborate tests include Endometrial biopsy to confirm the presence of endometritis, Ultrasound or radiologic tests to characterize a tubo-ovarian abscess laparoscopy to confirm salpingitis visually A laparoscopy, if asked in the Questions, is indeed the best test to diagnose PID. Its not a practical option always since this is a common presentation in the OPD and will be impossible to do on every one . Regular OPD diagnosis is made by the clinical triad If a Laparoscopy is being done for some indication & the surgeon notices inflamed tubes, then it is diagnostic of a PID Also: Please note that for diagnosis of PID , any uterine procedure like hysteroscopy, HSG, sonosalpingography ,will all push in fluids through the Uterus and this can in fact increase the PID. [/INST] question: Endosalpingitis is best diagnosed by | options: A: laparoscopy B: X-Ray abdomen C: Hysterosalpingography D: Hystero-laparoscopy | answer: A </s> |
<s>[INST] context: Climate change will increase U.S wildfires, and the smoky air will cause terrible problems in areas far beyond those burned, reports an environmental group Thursday.
Two-thirds of Americans, or nearly 212 million, lived in states suffering from wildfire smoke three years ago, according to the report by the Natural Resources Defense Council (NRDC). These areas, which had smoke for at least a week, were nearly 50 times greater than those burned directly by fire.
" It affects a much wider area of the United States than people have realized, " says author Kim Knowlton, a Columbia University health professor, adding the smoke can move up to hundreds of miles. She says the smoke contains air pollution and can cause several kinds of disease.
Texas was hit hardest in 2011, when smoke stayed for at least a week in areas that are home to 25 million people, according to NRDC's report. Illinois, which recorded no wildfires within its borders( ) ,ranked ( ) second with nearly 12 million people affected by smoke that moved in from elsewhere. The other eight states with the most people exposed ( ) to smoky air were, in descending ( ) order: Florida, Missouri, Georgia, Louisiana, Michigan, Alabama, Oklahoma and Iowa.
Nearly two dozen states had no wildfires within their borders in 2011, but eight of them still had at least one week of smoky air: Illinois, Missouri, Iowa, Kansas, Nebraska, Indiana, Wisconsin and Ohio.
Only 18 states and the District of Columbia had no people exposed to at least a week of smoke that year, although five of them----Alaska, California, Hawaii, Nevada and Utah---had a large area burned by wildfires.
The problem will only get worse, Knowlton say. Scientific research shows climate is causing higher temperatures and health problems. [/INST] question: Which of the following states had wildfires within its borders? | options: A: Texas B: Kansas C: Ohio D: California | answer: D </s> |
<s>[INST] context: Diagnosis : Double vision + Ptosis at the end of the day + weaker at the end of the day= Myasthenia Gravis Option B- Feels stronger at the end of the day. Option C- Presents with gait ataxia, nystagmus, head impulse test negative. Option D- Atypical parkinsonism associated with Cog wheel rigidity, Bradykinesia, Postural instability. Myasthenia gravis (MG) is a relatively common neuromuscular disorder that is caused by antibody-mediated autoimmune destruction of acetylcholine receptors at the neuromuscular junction(Post Synaptic) * Type V Hypersensitivity reaction > Type II Hypersensitivity Reaction. * Receptor of Acetyl choline are affected. It is a post junctional defect. Diagnosis: 1. Anti Ach Receptor blocking Antibody 2. Anti-MUSK Antibody 3. Anti LRP 4 Antibody 4. Single fiber electromyography (SFEMG)=Jitter and blocking - Confirmatory test 5. Repetitive nerve stimulation test. 6. Tensilon test, Or Anticholinesterase test. The treatment of MG may include: Anticholinesterase medications (Pyridostigmine), Immunosuppression, IVIg or plasmapheresis, Surgical intervention( Thymectomy). [/INST] question: A 65-year-old male comes to the OPD complaining of ongoing double vision which is worse when he is watching TV in the evening. He has also noticed that he feels weaker towards the end of the day and that his face is slightly puffy. On inspection, there is a paial ptosis of the left eye lid and his mouth hangs slightly open at rest. On examination, there are visibly distended neck veins. What is the most likely diagnosis? | options: A: Myasthenia gravis B: Lambe Eaton syndrome C: Paraneoplastic cerebellar degeneration D: Multiple system atrophy | answer: A </s> |
<s>[INST] context: We have to accept the truth: Sometimes, we just want to shout out loud.
For example, we all have days like this: our dog has made a mess on the floor we just cleaned, or our friend called to tell us he or she couldn't come at the last minute when we had cooked dinner for him or her. We may be really angry but we tried to bear things like those. According to ancient Chinese wisdom, we should shout in a loud voice instead of keeping silent. In fact, it's good for our health.
"Chinese people have passed on the practice from ancient times to now as a part of traditional medicine," said Mrs. Li, a 60-year-old woman from Hangzhou. "My parents taught me to do this. It's a part of our folk culture. "
Mrs. Li is a member of a group of people who love shouting. Each morning, she and some of her friends climb to the top of a hill and let out loud shouts before starting their daily exercise. They believe that shouting is good exercise for their lungs and it brings them a lot of fun.
"Sometimes I shout out and other shout back," said Mrs. Gu, another shouting lover. "It makes you happy. You laugh and then you feel very comfortable. "
Dr. Peter Calafiura, an American doctor, agrees that shouting can have a positive influence on people's health.
So, next time you start your morning run, why not try to shout out first? It will make you healthier. [/INST] question: Mrs. Li learnt to shout to make herself feel better from _ . | options: A: her parents B: her teacher C: Mrs. Gu D: Dr. Peter Calafiura | answer: A </s> |
<s>[INST] context: Option c - laugh out loud - 4 months Option b - rolls over - 5 months Option a - immature pincer grasp - 9 months Option d - 1-2 words with meaning - 12 month Table:- key groups motor development milestones Age Milestone 3 months Neck holding 5 months Rolls over 6 months Sits in tripod fashion (sitting with own suppo) 8 months Sitting without suppo 9 months Stands holding on (with suppo) 12 months Creeps well; walks but falls; stands without suppo 15 months Walks alone; creeps upstairs 18 months Runs; explores drawers 2 year Walks up and downstairs (2 feet/step); jumps 3 years Rides tricyclic; alternate feet going upstairs 4 years Hops on one foot; alternate feet going downstairs Table:- Key fine motor milestones Age Milestone 4 months Bidextrous reach (reaching out for objects with both hands) 6 months Unidextrous reach (reaching out for objects with one hand); transfers objects 9 months Immature pincer grasp; p[robes with forefinger 12 months Pincer grasp mature 15 months Imitates scribbling; tower of 2 blocks 18 months Scribbles; tower of 3 blocks 2 years Tower of 6 blocks; veical and circular stroke 3 years Tower of 9 blocks; copies circle 4 years Copies cross; bridge with blocks 5 years Copies triangle: gate with blocks Table: Key social and adaptive milestones Age Milestones 2 months Social smile (smile after being talked to) 3 months Recognizes mother; anticipates feeds 6 months Recognizes strangers, stranger anxiety 9 months Waves "bye bye" 12 months Comes when called; plays simple ball game 15 months Jargon 18 months Copies parents in task (e.g. sweeping) 2 years Asks for food, drink, toilet; pulls people to show toys 3 years Shares toys; knows full name and gender 4 years Plays cooperatively in a group; goes to toilet alone 5 years Helps in household tasks, dresses and undresses Table: key language milestones Age Milestone 1 month Ales to sound 3 months Coos(musical vowel sounds) 4 months Laugh loud 6 months Monosyllables (ba, da, pa), ah-goo sounds 9 months Bisyllables (mama, baba, dada) 12 months 1-2 words with meaning 18 months 8-10 word vocabulary 2 years 2-3 word sentence, uses pronouns "I", "me", "you" 3 years Asks questions; knows full name and gender 4 years Says song or poem; tells stories 5 years Asks meaning of words [/INST] question: Arrange the following developmental milestones in order of appearance (age wise) (first to last) a. Immature pincer grasp b. Rolls over c. Laugh loud d. 1-2 words with meaning | options: A: c- b, a- d B: d- b, a- c C: a- b, c- d D: c- d, a- b | answer: A </s> |
<s>[INST] context: When the Spanish first brought chocolate back to Europe,it was still being served as a drink,but soon went through an important change:the chili pepper was replaced by sugar. The new sweetened chocolate drink was so expensive that few could afford,but by the 17th century the drink was common among European noblemen. In England,which was somewhat more equalityfavored than the rest of Europe,chocolate was more widely available. Those who could afford it could enjoy chocolate drinks in the new coffee and chocolate houses of London.
As cacao tree became more commonly available,people began experimenting with new ways of using it. Chocolate began to appear in cakes and other foods. But it wasn't until 1828 that the "modern ear" of chocolate making and production began.
The introduction of cocoa powder not only made creating chocolate drinks much easier,but also made it possible to combine chocolate with sugar and then remix it with cocoa butter to create a solid. Others began to build on Van Houten's success,experimenting to make new chocolate products. In 1849,English chocolate maker Joseph Storrs Fry produced what was the world's first eating chocolate.
Today,the Swiss are famous for their chocolate,and rightly so. In the late 19th century,they developed a number of processes that contributed greatly to creating the solid chocolate candy that we all enjoy today. Two major developments occurred in 1879.First,Daniel Peter,a Swiss chocolate producer,had the idea of using powdered milk (invented by Swiss Chemist Henri Nestle in 1867) to make a new kind of chocolate,milk chocolate. Second,Rudolph Lindt invented a process called "conching",which greatly improved the quality of chocolate candy by making it more mixable. [/INST] question: Before being brought into Europe by the Spanish,chocolate was served as _ . | options: A: a sweet candy B: a spicy drink C: a sweet drink D: a spicy candy | answer: B </s> |
<s>[INST] context: Offering a powerful new tool against terrorism, researchers have found a way to detect lies in the liar's blushing face. The technique, described in the journal Nature, uses a thermal camera to detect the sudden shift of blood flow in the face. The system performed as a traditional polygraph , the scientists report.
Pushed by technological advances and with fresh interest since Sept.11, the discovery is part of the development in the scientific study of detection. Although the lie remains a mysterious phenomenon, researchers in recent years have found a number of new methods that might take the place of the polygraph, from brain scans, to slight changes in eye movement, to sparks of electrical activity that signal a person has seen a victim or a crime scene before. The new finding says, when a person tells a lie, there is a sudden change of blood to the area around the eyes. Although the change is not ordinary visible, the blood warms the skin, causing bands of color1 to appear through a camera sensitive to heat.
One advantage of the camera can provide answers quickly, and doesn't require a highly trained expert to operate it or explain its results. In theory, this new technology could be used anywhere large numbers of people need to be quickly screened.
But some scientists say the technology would need to be improved before it is ready for use, for it is possible that there are other reactions that cause a sudden change in blood flow in the face and there is also the danger that people will learn to fool the machine, the same way they try to fool polygraph examiners by controlling their breathing or taking drugs to relax themselves. [/INST] question: Compared with a traditional polygraph, the new tool's progress lies in the fact that _ . | options: A: it is moveable B: it is easier to operate C: it gives correct conclusion D: it can only be used in public places | answer: B </s> |
<s>[INST] context: Baymax, a new Disney character, has made everyone like him and want to hug him. The big robot is from the Disney movie--- Big hero 6. He lives with a fourteen-year-old smart boy called Hiro Hamada. Baymax has helped Hiro get through hard times after Hiro's elder brother died in an accident. Soon Hiro finds that some bad people are behind his brother's death and want to take the city. To stop it , he uses his high-tech gadgets and turns Baymax and his four other friends into super heroes. The movie has received very good feedback . In February, the movie won the best animation feature of the 87thOscar Awards. Baymax has become popular thanks to his big soft body and his comforting voice. People say his love can be found on the screen.
Mothers in Japan have started to make Baymax-sharped white rice balls for children. In China, fans warmly call him "the big white". The friendship between Baymax and Hiro makes many people cry in the cinema. As a nursing robot, Baymax is never designed to be a super hero. He dares to love you without expecting anything for himself. I think we all love him because of his love. [/INST] question: What is Baymax? | options: A: A big robot B: A popular movie C: A smart boy D: A bad people in the movie | answer: A </s> |
<s>[INST] context: Dermatitis herpitiformis Chronic blistering skin disease characterised clinically by intensely pruritic grouped vesicles on a erythematous base. Etiology and pathogenesis: Neutrophilic infiltration in dermal papillae, granular IgA deposition in papillary dermis , gluten sensitive enteropathy. Antibodies to gliadin are present in some patients Associated with HLA-DQ2 and HLA -DQ8. Autoantibodies are formed against epidermal transglutaminase(TGe) forming IgA precipitates at papillary tips. Dermal deposition of circulating immune complexes at the papillary tips and activation of complement leads to bullae formation Clinical feature: Age- most common -20-30years Males>females Onset-acute/gradual Skin lesions-polymorphous lesions-papular, uicarial,vescicular,bullous. Primary lesion: small vesicle on a erythematous edematous base, erythematous papule or uicarial plaque Grouped vesicles in herpetiform manner. Intense itching leading to excoriations and crusts Areas of predilection: elbows , knees, buttocks, scrotum, shoulder, posterior hair line,scalp Symetricall distribution over extensor surfaces Associations- gluten sensitive enteropathy,diabetes mellitus type1, connective tissue disorders, gastric hypochlorhydria,thyroid disease, lymphomas Histopathology: neutrophilic microabcesses at dermal papillary tips Direct immunofluorescence: granular deposits of IgA at dermal papillary tips appears as PICKET FENCE Serological tests: circulating anti endomysial, antireticulin anti tissue trans glutaminase antibodies of IgA type Treatment: Dapsone is the drug of choice. Gluten free diet Otherdrugs- sulfasalazine,colchicine,cyclosporine,azathioprine.,prednisolone. IADVL textbook of dermatology, page 1119 [/INST] question: A 30 year old male had severely ithcy papula vesicular lesions on extremities, knees, elbows and butocks for one year. Direct immunofluorescence staining of the lesions showed IgA deposition at dermal papillary tips. The most probable diagnosis is | options: A: Pemphigus vulgaris B: Bullous pemphigoid C: Dermatitis herpetiformis D: Nummular eczema | answer: C </s> |
<s>[INST] context: Treatment of anterior uveitis
The mainstay of therapy of acute anterior uveitis is eye drops. These usually include:-
Corticosteroids:- They are used along with mydriatic - cycloplegics. They act by reducing inflammation; and reducing fibrosis. Corticosteroids are the drug of choice for acute anterior uveitis.
Mydriatic - cycloplegic (Atropine 1%):- These are most useful and most effective during acute anterior uveitis (iridocyclitis). They act by:-
Gives comfort and rest to the eye by relieving spasm of iris sphincter and ciliary muscle
Prevents the formation of synechiae and may break the already formed synechiae
Reduces exudation by decreasing hyperemia and vascular permeability
Increases the blood supply to anterior uvea by relieving pressure on the anterior ciliary arteries. As a result, more antibodies reach the target tissues and more toxins are absorbed.
Symptomatic treatment is given for pain relieves, Eg: hot applications (warm compresses), aspirin (or other NSA1Ds).
Systemic steroids are indicated in severe uveitis or where there is no improvement in maximal topical steroids.
Systemic immunosuppressives (cyclosporin, methotrexate and cyclophosphamide) are indicated in some cases which do not respond to conventional steroid therapy.
Along with the symptomatic treatment of uveitis (described above), the specific treatment of underlying cause is also required, for example, removal of the lens in lens-induced uveitis. [/INST] question: Treatment of choice for acute anterior uveitis is – | options: A: Local steroids B: Systemic steroid C: Local NSAIDS D: Systemic NSAIDS | answer: A </s> |
<s>[INST] context: Compulsive shoppers may have a new psychological excuse to blame for their wild shopping. Psychologists at the University of Canterbury in New Zealand are studying the "shop-till-you-drop" habit as a behavioral disorder similar to compulsive eating. Compulsive shoppers frequently buy more than they can afford or more than they need, and it causes them distress .
"It becomes a problem when you are out of control," psychology lecturer Neville Blampied said. "When you are feeling bad and blue, what do you do? Some people eat chocolate cake and ice cream. Some people take the credit card and go out to the shop." Bank managers understand the problem because they have to deal with people who have to be persuaded to stop using their cards drawing money.
Compulsive shopping was first discovered in 1915, although it was then known as monomania. Few studies have been done on the problem.
An advertisement in a Christchurch paper, calling for people to take part in an experimental treatment program designed by Mr. Wilson, attracted 10 replies. But the problem, said Mr. Wilson, is "clearly not rare". He thinks that compulsive shopping should be treated with drugs. "As psychologists we are interested in non-drug treatments for behavioral difficulties," Mr. Wilson said.
Compulsive eaters or shoppers get a kick from their habit. "Both activities provide an immediate kind of kick and you feel a bit better," he said. "You have long-term problems, but human beings are extremely good at not seeing long-term problems and are very sensitive to short-term benefits," he said.
The aim of the treatment was to help people find better ways of managing their emotions. The program, consisting of 10 one-hour weekly lessons and two follow-up treatments, is loosely based on teaching stress management.
"You often have to start to get people to correctly recognize their emotions. Not being able to know what you really feel weakens your ability to solve the problems connected with what's making you feel that way," Mr. Wilson said. [/INST] question: The compulsive shoppers will go shopping when _ . | options: A: they have lots of money B: they are taking drugs C: they are feeling sad D: they win a prize | answer: C </s> |
<s>[INST] context: When used as an anaesthetic opioids may caue muscle rigidity. - Opioid induced rigidity is characterized by increased muscle tone progressing at times to severe stiffness. - When the rigidity increases and involves thoracic and abdominal muscle, it may impair ventilation. - Rigidity of the abdominal and/or thoracic muscles was thought to underlie opioid induced impairment of spontaneous or controlled ventilation. The precise mechanism by which opioids can cause muscular rigidity is not clearly understood. Muscle rigidity is not due to direct action on muscle fibres because it can be decreased or prevented by pretreatment with muscle relaxants. In addition, opioid induced muscle rigidity is not associated with increase in creatinine kinase a .finding suggesting that little or no muscle damage occurs during this period. - Opioids do not have any significant effect on neuromuscular conduction and result in only minimal depression of monosynaptic reflexes associated with muscle stretch receptors. - Some investigators have suggested that opioids produce rigidity by altering dopamine concentrations within the striatum.s of the brain. Rigidity may occur due to the result of stimulation of GABA ergic interneurons which can be blocked by lesion in the striatum. Continuous research and data seems to indicate that the main mechanism responsible for opioid induced muscle rigidity is stimulation of it receptors. - Opioids appear to produce their physiological effects by.binding to at least three types of opioid receptors the mu (p), delta (8) and Kappa (x) receptors. - Muscle rigidity occurs after administration of supra analgesic doses of potent p preferring opioids. - The present data demonstrates that whereas systemic opiate induced muscle rigidity is primarily due to the activation of central mu receptors, supraspinal delta and kapp receptors may attenuate this effect. Anaesthesia review by Michelle Bowman Howard states (p134) -All opioids given in high doses may cause muscular rigidity. It is most likely related to I.i receptors in the caudate nucleus. It is more commonly seen with Fentanyl. [/INST] question: Muscle rigidity due to opiods is becasue of their effect on aEUR' | options: A: >mu B: >kappa C: Sigma D: >delta | answer: A </s> |
<s>[INST] context: Spermicides
"Spermicides are contraceptive chemical agents. They comprise,of a chemical capable of destroying sperm, incorporated into an inert base. The commonly used spermicidal agents contain nonionic surfactants which alter sperm surface membrane permeability, causing osmotic changes resulting in killing of sperm. Most of the spermicides contain nonoxynol-9 which is the best for this purpose." Ref. Current Concepts in Contraception and Women Health by Jaypee Publication p 32
Spermicidal agents kill the sperms before it enters to the cervical canal. They are available as foam tablets, soluble pessaries, creams, jellies, or as films.
Contents are:
Nonoxynol - 9 (N - 9)
Menfegol
Benzalknonium chloride.
Octoxynol
Enzyme inhibiting agents
Failure rate is 20-25 WY 100 woman years when used alone. When used in conjunction with a mechanical barrier, they give a reliable contraceptive effect.
Note:
Recent evidences indicate spermicides are not effective in preventing cervical gonorrhoea, Chlamydia or HIV infection. In addition, frequent use of spermicides containing N-9 has been associated with an increased risk of HIV transmission.
Advantage 24 is a new contraceptive gel which contains nonoxynol. [/INST] question: Spermicidal agents are:a) Nonoxynolb) Menfegolc) Progestasertd) Mirena | options: A: ac B: a C: ab D: bc | answer: C </s> |
<s>[INST] context: DNA is the whole "map" of the human body. It is something that all human have, and it tells the body what to do. DNA is the reason that we look like our parents, because we get some of their DNA to make our own.
People have been trying to understand the human body for a long time. In 1860, Mr. Mendel discovered why we look the same as other people in our family. It is because of small things called "genes" in our body. In 1953, two scientists, Watson and Crick, found out that those small parts are really messages. They're written in the DNA with a special language.
In 1961, another two scientists found the first "word" that they could understand in that language. It shows how DNA tells the cell to build its parts. So far, scientists have found all the words in the DNA map, but we still do not understand what they all do. By understanding what just one "word" means, we can help to save people from several illnesses. So the more we understand, the more doctors will be able to do.
Most people hope that this will help to make better medicine and help sick people. Other people worry that when we learn more "words" and and find out more information, we will use it in the wrong way, just to make people more attractive, or stop sick people getting jobs. [/INST] question: When did Mr. Mendel discover why we look the same as other people in our family? | options: A: In 2000 B: In 1961 C: In 1953 D: In 1860 | answer: D </s> |
<s>[INST] context: iPhone 6, which many people have been thirsty for, will be unveiled on September 9. It could go on sale to the public from Friday, September 19.
Apple has launched a new iPhone every year since it unveiled the range in 2007, selling more than 500 million units since then, and has traditionally launched key products in September.
The iPhone 6, Apple's ninth iPhone model, is expected to be released in two different sizes:4.7-inches and 5.5-inches. The smaller of the two will be available first. Like iPhone5, the new model will come in silver , gold and space grey.
The iPhone 6 will be powered by new operating system iOS 8. Through iOS8, users will be able to monitor their health and fitness via HealthKit. HealthKit puts together numerous healthcare and fitness apps, such as blood pressure and heart rate monitors through partners including Nike, and allows them to communicate with each other.
Users will be able to control home appliances and other connected devices through HomeKit, Apple's connected home framework. Similar to HealthKit, this app will organize your smart devices to control them in one place. One method of control will be via Siri-for example, you could tell Siri you were "going to bed", and it could dim the lights, lock your doors, close the garage door and set the room temperature.
With the introduction of both of these key features, it's likely the iPhone 6 will take on even more of a lifestyle device role. It is designed to organize our lives and make everyday tasks easier and more efficiently completed.
Suppliers are believed to be preparing to produce up to 80m of the new handsets by the end of December, according to the Wall Street Journal. In July, Apple announced strong financial results for its third quarter, with significant sales growth in China and profits ahead of expectations at $7.7bn. [/INST] question: If you are a customer, when can you buy an iPhone6? | options: A: After December 31 B: From September 19 C: After September 9 D: At the moment | answer: B </s> |
<s>[INST] context: creamy curd like white patch on tongue is diagnostic of candidiasis. In lichen planus ,Classic lesion- small polygonal shaped, and red/ violet, flat topped papule. Four Ps- purple polygonal pruritic papule. In histoplasmosis-lesions are erythema nodosum like lesions,erythema multiforme like lesions and non specific lesions appear as papules,pustules and nodules. Candidiasis/ moniliasis Superficial infection of skin and mucous membranes by yeast Candida. albicans. Sometimes systemic spread occurs causing systemic disease. Candida is yeast that produces budding cells, pseudohyphae and hyphae. Most common species: Candida albicans and Candida tropicalis. Sites of carriage: Cutaneous: body orifices and fingers, moist interigenous areas. Gastrointestinal: oral cavity,rectal other pas of GIT yeast forms are present. Vaginal : health vagina colonise yeasts Pathogenic forms: pseudohyphae and hyphae Predisposing factors for Candida infection: Extremes of age Illness Tissue damage diabetes Immunodeficiency Antibiotics Cushings Addisons Hypothyroidism HIV CLinical presentation Cutaneous candidiasis: Flexural candidiasis/ interigo-involves skin folds. Minor erythematous exudates fringed edge and satellite pustules are characteristic. Perleche is candidiasis at corners of mouth, erosio interdigitalis blastonycetia candidiasis of web spaces. Napkin candidiasis Candidal miliria Candidal paronychia- swelling and redness of nail folds Neonatal candidiasis: presents after 6th day as diaper dermatitis or thrush Oral candidiasis: Oral thrush: curry white patches covered by pseudo membrane Candidal leukoplakia Median rhomboid glossitis Angular chelates/perleche Vulvovaginal candidiasis: presents as white discharge curdy white with erythema Candidal balanitis: linear fissures, erythematous areas with circinate borders Chronic mucocutaneous candidiasis systemic candidiasis- esophageal, bronchial type Investigations Direct determination of pseudohyphae and yeasts: KOH Mount and grams stain Culture:saborouse dextrose agar Reynolds braude phenomenon:when Candida grown in human or sheep serum at 37 c for 3 hrs, forms germ tubes. It is positive for Candida albicans and Candida dubiliniensis. Treatment: antifungals azole group of drugs Iadvl textbook of dermatology page 254 [/INST] question: A 60 year old male presents with a creamy curd like white patch on the tongue. The probable diagnosis is - | options: A: Candidiasis B: Histoplasmosis C: Lichen planus D: Aspergillosis | answer: A </s> |
<s>[INST] context: The total serum thyroxine (T4) represents the sum of the T4 bound to thyroid-binding globulin (TBG) and the free T4. An increased total T4 may be due to an increase in TBG or an increase in free T4, the latter leading to signs of thyrotoxicosis. A decreased total T4 may be secondary to a reduction in TBG or in free T4, the latter leading to signs of hypothyroidism. In a euthyroid state, one-third of the binding sites on TBG are occupied by T4. An increase in estrogen (pregnancy, bih control pills) increases the synthesis of TBG. Since one-third of the binding sites on TBG will be occupied, the T4 bound to the additional TBG increases the total serum T4. The addition of extra TBG does not alter the free T4 level because of the equilibrium between the serum concentration of T4 and thyroid gland T4 production. Since the free T4 level is normal, there is no stimulus to release thyroid-stimulating hormone (TSH) from the pituitary gland. Regarding the patient's enlarged thyroid gland, heat intolerance, and palpitations, these are normal findings in pregnancy and do not indicate an overactive thyroid gland. Estrogen is increased (not decreased) in pregnancy. The serum free T4 is normal in pregnancy. This explains why the serum TSH is normal in the presence of an elevated serum T4, which reflects the increase in TBG normally occurring in pregnancy. The increase in progesterone during pregnancy has no effect on TBG levels. [/INST] question: A pregnant woman in her second trimester complains of heat intolerance and palpitations. Physical examination reveals a slightly enlarged, non-tender thyroid gland, and a normal cardiac exam. The serum thyroxine (T4) level is increased; however, the serum thyroid-stimulating hormone (TSH) is normal. Which of the following best explains the laboratory findings in this patient? | options: A: Decreased estrogen B: Increased free thyroxine (T4) C: Increased progesterone D: Increased thyroid-binding globulin (TBG) | answer: D </s> |
<s>[INST] context: Answering the Community Needs of Our City
The Silver City Council recognizes that citizens have certain needs. To better meet your needs, we have made several changes to community facilities in 2004. This chart shows how we have tried to make your life better.
Transport Three stations for the suburbs have been added to the western train service.20 new buses for the southern line were purchased in January. 50 percent of city bus-stops have been upgraded . Buses to the eastern suburbs will run every15 minutes.
Communication Broadband cable is now available to all parts of the city. All of the new Government buildings are ' smart'-wired for better computer service!
Medical Facilities The new state-of-the-art Nightingale Hospital was opened in June. To overcome a shortage of trained medical staff at Dover Hospital, 10 doctors have been employed from overseas.Some facilities at Station Street Hospital have been upgraded.
Education Textbooks will be free to all primary students in 2004 ! Rent for private schools has been reduced. Teachers report that the 'no hat - no play' rule has been successful.
Protection and Security Extra police now patrol ( ) the tourist areas. 50 new police officers graduated in July and have taken up duties in the city area.
Entertainment / Recreation The John Street basketball courts have been re-surfaced ! The new Central Community Building opened in May. 5,000 new fiction books were bought for the Silver City Library. [/INST] question: The public notice is from _ . | options: A: the community B: the local government C: The citizens D: a travel agency | answer: B </s> |
<s>[INST] context: Dear Mr./Ms,
I would like to suggest that the starting time be changed at our school. Classes at Sebastian Valley Middle School simply start too early in the morning. Getting eight to nine hours of sleep each night is almost impossible when classes begin at 7:30 am. In order to shower, dress, get organized, eat a quick breakfast, and meet the school bus by 6:45, I would have to get up at 5:45.
Early in the morning, students are too sleepy to learn well. Without enough sleep, young people cannot think clearly or enjoy learning. According to a report called "Are Students getting Enough Sleep?" From Sebastian Valley Times, "Sleepiness disturbs concentration, reduces short-term memory, and causes bad feelings."
Researchers have learned that teens normally fall asleep and wake up later than adults. Teens who stay up late at night have trouble getting up early in the morning. Studies show that some schools have already adjusted school hours to better match the teen sleep cycle , as a result, students in these school are learning better on the new schedule .
Some of my classmates argue that starting school an hour later will prevent them from taking part in after-school athletic programs. A solution would be to carry out these programs before school instead of after school. The students who are involved in sports and clubs would continue to arrive at the usual time. The rest of the student body could get a little more sleep and arrive an hour later.
Teens usually have a later sleep cycle, and learn and behave better when rested. So I would like to suggest that we have a meeting to discuss the problem and listen to all the students' voice.
Thank you for considering this request ! [/INST] question: In Tom's opinion, classes should begin at _ . | options: A: 6:45 B: 7;30 C: 8:00 D: 8:30 | answer: D </s> |
<s>[INST] context: <Tinea capitis it is is superficial fungal infection of scalp and hair with dermatophytes . Commonest mycosis in children's Fungus grows over scalp and extend down in hair follicles till zone of keratinisation-adamsons fringe. According to the inflammatory component of clinical presentation tinea capitis classified as Inflammatory-keerion and us Non inflammatory- grey patch and black dot According to size and location of spores Ectothrix-spores outside hairshaft hairs appear dull and grey Endothrix-spores inside hair shaft- hairs break at the follicular orifices appear as black dots on scalp Clinical presentation :four different clinical presentations Grey patch or non inflammatory type:patches of hair loss with broken dull looking hairs.causative organism- microsporum audounii,M.canis,M.gypseum Kerion or inflammatory type : kerion is a inflammatory boggy swelling , indurated tender swelling that is studded with broken ,unbroken hairs , vesicles and pustules. There is sinus formation thick crusting.heals with scarring. Causative organism trichophyton verrucosum and trichophyton mentagrophytes Black dot or non inflammatory type: endothix infection.hairs break at the level of scalp appear as black dot on scalp. Favus: inflammatory type: yellow cup shaped crust composed of dense meat of mycelia and debris-scutula.concavity of cup faces up.endemic in Kashmir. Causative organism T.schoenleinii. Diagnosis: Woods lamp: Bright green fluorescence- M.canis,M.audounii,M.gypseum Dull green fluorescence- T.schoenleinii Direct demonstration KOH mount Treatment Drug of choice for tinea capitis-griseofulvin 15-25mg/kg/day for 2-4 months Other drugs- itraconazole ,fluconazole,terbinafine Topical therapy not effective Antifungal shampoos like ketoconazole and selenium sulphide decrease carrier state. iadvl textbook of dermatology page 254 [/INST] question: Hair infection with scutula formation is seen is case of- | options: A: Tenia Capitis B: jock Itch C: Tenia glabrosa D: Tenia barbae | answer: A </s> |
<s>[INST] context: Ligation technique is reserved for intractable bleeding where the source cannot be located or controlled by other techniques.
The hierarchy of arteries used for ligation is:
Sphenopalatine artery
Internal maxillary artery
External carotid Artery
Anterior/posterior ethmoidal artery
Earlier the most common artery ligated was maxillary artery but now endonasal sphenopalatine artery ligation (ESPAL) is the ligation of choice.
“ESPAL is the current ligation of choice controlling bleeding in over 90% of cases with a low complication rate.”
Transnasal Endonasal Sphenopalatine Ligation (TESPAL or ESPAL)
It is the most popular procedure for ligation and has replaced internal maxillary artery ligation.
Can be done under LA/GA
Incision is given 8 mm anterior and under the posterior end of middle turbinate
Sphenopalatine artery is ligated in the sphenopalatine foramenQ
Success rate ~100%
Complications very rare – rebleeding, infection and nasal adhesions
Internal Maxillary Artery Ligation
Earlier it was the ligation procedure of choice for uncontrolled bleeding:
Internal maxillary artery is ligated in the pterygopalatine fossa using a Caldwell-Luc approach (3rd part of the artery is ligated)Q
Success rate – 89%
Complications – Sinusitis, damage to infraorbital nerve, oroantral fistula, dental damage and anesthesia, and rarely ophthalmoplegia and blindness.
External carotid artery ligation and anterior and posterior ethmoidal artery ligation is not commonly done. [/INST] question: If posterior epistaxis cannot be controlled, which artery is ligated - | options: A: Posterior ethmoidal artery B: Maxillary artery C: Sphenopalatine artery D: External carotid artery | answer: C </s> |
<s>[INST] context: This child has :-
Hypocalcemia
Hyperphosphatemia
Normal PTH levels
Option b & d can be ruled out because:-
In Vitamin D deficiency:- serum calcium is normal or slightly reduced (7.5 8 mg/dl); serum P043 is normal or slightly reduced, and parathormone levels are increased.
hypoxic-ischemic encephalopathy is not related to calcium and phosphate metabolism.
Now, we are left with Pseudohypoparathyroidism and hypoparathyroidism both of which have hypocalcaemia and hyperphosphatemia.
In Pseudohypoparathyroidism, there is an increased concentration of parathyroid most of the times. Thus, this option is also excluded.
Coming to hypoparathyroidism: As the name suggests, PTH is low in hypoparathyroidism. But, sometimes PTH may be in normal range (10-60 Pg/ml) and this is inappropriately normal PTH.
However, it is generally believed that 'Normal' levels of PTH in a patient with hypocalcaemia indicate 'inappropriately normal PTH' and relative Hypoparathyroidism should always be considered as the initial diagnosis. `Serum PTH levels should be related to the concurrent serum calcium. High PTH is the normal response to hypocalcaemia and therefore 'normal' PTH in a patient with Hypocalcaemia indicates relative Hypoparathyroidism' Practical Algorithms in Pediatric Endocrinology' by Hochberg (2007)/71.
Because normally hypocalemia is a potent stimulus for secretion of PTH, patients with intact parathyroid gland function should be expected to have high circulating levels of PTH, during hypocalcaemia episodes. Low levels of serum PTH and in some assays even inappropriately 'normal' levels despite hypocalcaemia should prompt consideration of various form of hypoparathyroidism' - Principles and Practice of Endocrinology & Metabolism ' by Beeker. [/INST] question: A 15 days old baby is brought to the hospital with complains of seizures.;Mood tests revealed serum Ca++ = 5 mg/dL, Phosphorous levels = 9mg/dL, and PTH levels 30pg/ml (normal range = 10–60 pg/ml). What is the most probable diagnosis? | options: A: Pseudohypoparathyroidism B: Vitamin D deficiency C: Hypoparathyroidism D: Hypoxic ischemic encephalopathy | answer: C </s> |
<s>[INST] context: One day, a poor boy who was trying to pay his way through school by selling goods from door to door found that he had only one dime left. He was hungry so he decided to beg for a meal at the next house.
However, he became nervous when a lovely young woman opened the door. Instead of a meal, he asked for a drink of water. She thought he looked hungry so she brought him a large glass of milk. He drank it slowly, and then asked, "How much do I owe you?"
"You don't owe me anything," she replied, "Mother has taught me never to accept pay for a kindness." He said, "Then I thank you from the bottom of my heart." As Haward Kelly left that house, he not only felt stronger physically, but it also increased his faith in God and the human race. He was about to give up and quit before this point.
Years later, the young woman became seriously ill. The local doctors were _ . They finally sent her to the big city, where specialists could be called in to study her rare disease. Dr. Haward Kelly, now famous was called in for the consultation. When he heard the name of the town she came from, a strange light filled his eyes. Immediately, he rose and went down through the hospital hall into her room.
Dressed in his doctor's gown he went in to see her. He recognized her at once. He went back to the consultation room and determined to do his best to save her life. From that day, he gave special attention to her case.
After a long struggle, the battle was won. Dr. Kelly requested the business office to pass the bill to him for approval. He looked at it and then wrote something on the side. The bill was sent to her room. She was afraid to open it because she was positive that it would take the rest of her life to pay it off. Finally she looked, and the note on the side of the bill caught her attention. She read these words,
"Paid in full with one glass of milk."
(Signed) Dr. Haward Kelly
Tears of joy flooded her eyes as she prayed silently, "Thank You, God. Your love has spread through human hearts and hands." [/INST] question: After finishing the milk, the boy _ . | options: A: felt angry because what he was really hungry B: regretted that he didn't ask for any food C: felt more hungry than ever before D: had a stronger faith in God and the human race | answer: D </s> |
<s>[INST] context: Clinical features of PNH
A. Intravascular hemolysis
The main feature of PNI-I is increased intravascular hemolysis that results in
Hemoglobinemia
Hemoglobinuria
Hemosiderinuria
Increased urine urobilinogen
Decreased serum haptoglobin
Increased serum LDH
Increased serum bilirubin
The hemolysis is paroxysmal and usually occurs in the night because during sleep the pH of blood gets slightly reduced and acidic medium leads to activation of the complement.
B. Thrombosis
In PNH there is episodic thrombosis due to the absence of CD-59 on platelets, this results in the externalization of phosphatidylserine, a site for prothrombinase complexes and thus increase the propensity for thrombosis.
Intrabdominal veins are the most common sites of thrombosis that may result in Budd Chiari syndrome due to hepatic vein thrombosis.
C. Other features
Thrombocytopenia
Granulocytopenia
Decreased LAP score
Normoblastic hyperplasia of bone marrow
PNH patients are also at increased risk for developing acute myelogenous leukemia and aplastic anemia. [/INST] question: Which is not a feature of paroxysmal nocturnal hemoglobinuria - | options: A: Increased LAP score B: Thrombosis C: Thrombocytopenia D: Hemolysis | answer: A </s> |
<s>[INST] context: The Medical Termination of Pregnancy (MTP) Act of India It clearly states the conditions under which a pregnancy can be ended or aborted,
the persons who are qualified to conduct the abortion and the place of implementation, Women whose physical and/or mental health were endangered by the pregnancy,
Women facing the birth of a potentially handicapped or malformed child. Rape. Pregnancies in unmarried girls under the age of eighteen with the consent of a guardian.
Pregnancies in "lunatics" with the consent of a guardian. Pregnancies that result are a result of a failure in sterilization.
The length of the pregnancy must not exceed 2D weeks in order to qualify for an abortion. MTP Act of 1971 legalizes abortion on the following grounds: Therapeutic. Eugenic.
Humanitarian. Social. MTP Rules Only registered medical practitioner can perform MTPs.
Should only be done in Government hospitals or hospitals recognized by Government.
Consent of woman is required. If minor or mentally ill, written consent from guardian is required.
If the period of pregnancy is less than 12 weeks, the opinion of the single doctor is enough [/INST] question: According to the MTP Act, abortion can be done till | options: A: 20 weeks B: 12 weeks C: 28 weeks D: Till viability | answer: A </s> |
<s>[INST] context: Hi guys! I'm Lucy the ladybird and while I'm very much of a lady, I'm not actually a bird but a glowing red bettle with decorative black spots.
I'm a friendly little bug, to be honest, and simply like to be close with my pals as long as they handle me very gently. I don't bite humans but I do sink my teeth into aphids which, unlike me, are very harmful to all the plants. I milk the aphids just like people do with cows and I milk them dry of all the sap they have got from your poor plants. I'm a real gardeners' friend and love helping out around the place by pollinating flowers, tidying up plants' fallen leaves and helping to turn them into nice rich fertilizer to feed everything both above and below the soil, and naturally, being so attractive to look at, we are perfect living garden decorations.
One thing I can not tolerate is all that poisonous pollution from vehicles, garbage burning and other environmentally unfriendly acts that occur in the cities every single minute of the day and night. Pollution of any kind really chokes me to death, so these days, I only live in clean countryside areas, particularly cool ones where it rains and everything grows fresh and green from spring right through to autumn. In winter, when the weather is too cold for me to bear, then I find a nice place to sleep until the snow has gone and I can come back out to play.
Oh! I almost forgot to tell you that although I am not a bird I do have wings and can fly for short distances. So if you pick me up and let me run up and down your hands and arms, then please don't frighten me by screaming if I suddenly decide to take off! [/INST] question: What makes Lucy the Ladybird suffer most? | options: A: Heavy rains B: Cold weather C: Air pollution D: Aphids | answer: C </s> |
<s>[INST] context: Being sociable looks like a good way to add years to your life. Relationships with family, friends, neighbours, even pets, will all do the trick, but the biggest longevity boost seems to come from marriage or an equivalent relationship. The effect was first noted in 1858 by William Farr, who wrote that widows and widowers were at a much higher risk of dying than their married peers. Studies since then suggest that marriage could add as much as seven years to a man's life and two to a woman's. The effect holds for all causes of death, whether illness, accident or self-harm.
Even if the odds are stacked against you(the conditions are not favourable),marriage can more than compensate. Linda Waite of the University of Chicago has found that a married older man with heart disease can expect to live nearly four years longer than an unmarried man with a healthy heart. Likewise, a married man who smokes more than a pack a day is likely to live as long as a divorced man who doesn't smoke. There's a _ , however, as partners are more likely to become ill or die in the couple of years following their spouses; death, and caring for a spouse with mental disorder can leave you with some of the same severe problems. Even so, the odds favour marriage. In a 30-year study of more than 10,000 people, Nicholas Christakis of Harvard Medical School describes how all kinds of social networks have similar effects.
So how does it work? The effects are complex, affected by socio-economic factors, health-service provision, emotional support and other more physiological mechanisms .For example, social contact can boost development of the brain and immune system, leading to better health and less chance of depression later in life. People in supportive relationships may handle stress better. Then there are the psychological benefits of a supportive partner.
A life partner, children and good friends are all recommended if you aim to live to 100.The best social network is still being mapped out, but Christakis says:" People are interconnected, so their health is interconnected." [/INST] question: William Farr's study and other studies show that _ . | options: A: social life provides an effective cure for illness B: Being sociable helps improve one's quality of life C: Women benefit more than men from marriage D: Marriage contributes a great deal to longevity | answer: D </s> |
<s>[INST] context: Chronic myelogenous (or myeloid or myelocytic) leukemia (CML), also known as chronic granulocytic leukemia (CGL), is a cancer of the white blood cells. It is a form of leukemia characterized by the increased and unregulated growth of predominantly myeloid cells in the bone marrow and the accumulation of these cells in the blood. CML is a clonal bone marrow stem cell disorder in which a proliferation of mature granulocytes (neutrophils, eosinophils and basophils) and their precursors is found. It is a type of myeloproliferative disease associated with a characteristic chromosomal translocation called the Philadelphia chromosome. CML is now largely treated with targeted drugs called tyrosine kinase inhibitors (TKIs) which have led to dramatically improved long-term survival rates since the introduction of the first such agent in 2001. These drugs have revolutionized treatment of this disease and allow most patients to have a good quality of life when compared to the former chemotherapy drugs. In Western countries, CML accounts for 15-25% of all adult leukemias and 14% of leukemias overall (including the pediatric population, where CML is less common [/INST] question: A peripheral smear with increased neutrophils, basophils, eosinophils, and platelets is highly suggestive of - | options: A: Actute myeloid leukemia B: Acute lymphoblastic leukemia C: Chronic myelogenous leukemia D: Myelodysplastic syndrome | answer: C </s> |
<s>[INST] context: .Indications for cholecystectomy, * Gallstones--symptomatic. * Cholecystitis--acute, chronic. * Acalculous cholecystitis. * Empyema gallbladder. * Mucocele gallbladder. Approaches employed are * Open - Right subcostal incision (Kocher's). - Right paramedian. - Horizontal incision. - Mayo-Robson incision. * Laparoscopic approach. Technique After opening the abdomen, colon is pushed downwards and stomach medially. Duct--first method: Here Calot's triangle is dissected. Cystic aery is identified and ligated. Cystic duct is ligated close to the gallbladder. Gallbladder is separated from gallbladder fossa and removed. Haemostasis is maintained. Fundus--first method: It is done in difficult gallbladder due to dense adhesions. Fundus is separated from themliver bed. Dissection is carried proximally until cystic duct and cystic aery are identified, which are then ligated. Drain is placed, which is removed after 72 hours. On table cholangiogram is a must after cholecystectomy. ref : SRB&;s manual of surgery,3 rd ed,pg no 595 [/INST] question: In cholecystectomy, fresh plasma should be given | options: A: Just before operation B: 6 hours before operation C: 6 hours before operation D: 12 hour after operation | answer: A </s> |
<s>[INST] context: Last Friday a storm swept through two villages in the New Territories , destroying fourteen homes. Seven others were so badly destroyed that their owners had to leave them, and fifteen others had broken windows or broken roofs. One person was killed, several were badly hurt and taken to hospital, and a number of other people received smaller hurt. Altogether over two hundred people were homeless after the storm.
A farmer, Mr. Tan, said that the storm began early in the morning and lasted for over an hour.
"I was eating with my wife and children," he said, "when we heard a loud noise. A few minutes later our house fell down on top of us. We tried our best to climb out but then I saw that one of my children was missing. I went back inside and found him safe but very frightened."
Mrs. Woo Mei Fong said that her husband had just left for work when she felt that her house was moving. She ran outside at once with her children.
"There was no time to take anything," she said, "A few minutes later, the roof came down."
Soldiers helped to take people out of the water area and the welfare government brought them food, clothes and some other things. [/INST] question: How many homes altogether were destroyed in the storm last Friday? | options: A: Fourteen B: Twenty-one C: Twenty-nine D: Thirty-six | answer: D </s> |
<s>[INST] context: The nonspecific findings of anorexia, polydipsia and polyuria, vomiting, and unexplained fevers, along with the more specific laboratory abnormalities of glucosuria but normal blood sugar, abnormally high urine pH in the face of mild or moderate serum hyperchloremic metabolic acidosis, and mild albuminuria in the presence of normal serum protein and albumin, suggest Fanconi syndrome (also called global proximal tubular dysfunction). Fan- coni syndrome can be hereditary or acquired; hereditary forms are usually secondary to a genetic abnormality such as cystinosis, galactosemia, Wilson disease, and some mitochondrial abnormalities. A number of agents can cause Fanconi syndrome, including gentamicin (or other aminoglycosides), outdated tetracycline, cephalothin, cidofovir, valproic acid, streptozocin, 6-mercaptopurine, azathioprine, cisplatin, ifosfamide, heavy metals (e.g., lead, mercury, cadmium, uranium, platinum), paraquat, maleic acid, and toluene (from sniffing glue). The mechanism of action of these agents is through acute tubular necrosis, alteration of renal blood flow, intratubular obstruction, or allergic reactions within the kidney itself. Many of these toxic effects are reduced or eliminated with removal of the offending agent. Renal tubular acidosis (RTA) type 1 is a distal RTA, and has a positive urine anion gap, as does RTA type 4. Type 3 is not a recognized type of RTA. Congenital nephrotic syndrome is a rare version of nephrotic syndrome, characterized by edema early in infancy, with hypoalbuminemia. [/INST] question: A 6-month-old infant has poor weight gain, vomiting, episodic fevers, and chronic constipation. Laboratory studies reveal a urinalysis with a pH of 8.0, specific gravity of 1.010, 1+ glucose, and 1+ protein. Urine anion gap is normal. Serum chemistries show a normal glucose and a normal albumin with a hyperchloremic metabolic acidosis. Serum phosphorus and calcium are low. What is the best diagnosis to explain these findings? | options: A: Renal tubular acidosis (RTA) type 1 B: RTA type 3 C: RTA type 4 D: Hereditary Fanconi syndrome | answer: D </s> |
<s>[INST] context: When most people turn 21, they spend too much time partying and having fun. But when Adele turned 21, she did something completely different.
After going through a tough breakup , the British singer turned her pain into glory and recorded one of the most moving albums of the year.
The album,21, which was _ in January, has already hit the charts in 14 countries, according to the Billboard magazine.
It also noted that Adele made history as the first artist since the Beatles to have two top five singles and two top five albums in the charts at the same time (Adele's first album,19, was released in 2008. Each album is named for her age when she wrote it).
Now, after touring around the world for almost a year, the DVD of her live concert, released on November 29, is Adele's latest work.
Having topped the pre-order list ofAmazon. comfor over a month already, this one seems set to stay on top for a while.
Born in north London, Adele sang her way up honestly: In 2006, she was signed by England's XL Recordings on the strength of a three-song demo a friend of hers had posted on MySpace;within two years she had won the BRIT Awards 'Critics' Choice prize and been tipped by the BBC as the "Sound of 2008".
In 2009 she got the best new artist Grammy Award, and went on a world tour in support of the album19with a sold-out show in Los Angeles.
According to Adele herself, much of the inspiration of her music comes from one single breakup.
That's probably what has made the singer's success-that emotional certitude , according to Dickins.
"The key to great singers is believing every single word they sing, " he said. "And I think you believe every word that comes out of Adele's mouth. You can feel her life force through her voice. " [/INST] question: When she wrote album19, she is at the age of _ . | options: A: 21 B: 18 C: 20 D: 19 | answer: D </s> |
<s>[INST] context: Penguin Group
Ordinary People Change The World!
Penguin Group and TFK have partnered together to help teachers show their students how they can make the world a better place. Building the encouraging lives of historic figures including Amelia Earhart, Rosa Parks, Abraham Lincoln and Albert Einstein, this attractive program takes a look at the real life stories of ordinary young people who grew up to become extraordinary adults!
Download the classroom poster, student worksheets and teacher's guide provided below.
Classroom Poster : You can be a Hero, too. Classroom Poster
Teachers Guide : Ordinary People Series Teacher's Guide
Student Worksheet : Who's Your Hero? Worksheet
Student Worksheet : Hero Matchup Worksheet
PGA Junior League Golf
It Takes a Team!
TIME For Kids and PGA Junior League Golf have developed a program all about using teamwork to reach goals. Download this poster to get your students involved in the power and fun of teamwork and cooperation.
Encourage your class to go to timeforkids.com/teampoll and take the poll!
Classroom Poster : It Takes a Team!
International Fund for Animal Welfare(IFAW)
Cats, Dogs, & Us
TIME for Kids has partnered with IFAW to present an educational animal awareness program called Cats, Dogs, & Us. This project is sure to attract and engage students with discussion starters, in-class activity ideas, a video viewing guide, and many other in-depth and fun resources. Preview IFAW's Cats, Dogs, & Us video at http://ifaw.org/cats-dogs-and-us
Classroom Poster : Cats, Dogs, & Us Classroom Poster
Classroom Poster / Teachers Guide : Cats, Dogs, & Us Teachers Guide Full View
Teachers Guide : Cats, Dogs, & Us Teachers Guide Pages
Special Olympics
Special Olympics Project UNIFY(r)
in TIME and Special Olympics have teamed up to promote understanding of people's differences in the classroom, school and community. Special Olympics Project UNIFY(r) is an education-based project that uses sports and education programs to activate young people to develop communities where all youth are agents of change-promoting respect, dignity and support for people with mental disabilities.
TFK Extra : in TIME Project UNIFY(r) Student Guide
Teachers Guide : in TIME Project UNIFY(r) Teachers Guide [/INST] question: Who are the materials mainly intended for? | options: A: Teachers B: Parents C: Students D: Headmasters | answer: A </s> |
<s>[INST] context: BRITAIN is a popular tourist place. But tours of the country have pros and cons.
Good news
Free museums: No charge for outstanding collections of art and antiquities .
Pop music: Britain is the only country to rival (......)the US on this score.
Black cabs: London taxi drivers know where they are going even if there are never enough of them at weekends or night.
Choice of food: Visitors can find everything from Ethiopian to Swedish restaurants.
Fashion: Not only do fashion junkies love deeply and respect highly brand names such as Vivienne Westwood, Alexander McQueen; street styles are justly loved, too.
Bad news
Poor service: "It's part of the image of the place. People can dine out on the rudeness they have experienced," says Professor Tony Seaton of Luton University's International Tourism Research Center.
Poor public transport: Trains and buses are promised to defeat the keenest tourists, although the over-crowded London tube is inexplicably popular.
Lack of language: Speaking slowly and clearly may not get many foreign visitors very far, even in the tourist traps.
Rain: Still in the number one complaint.
No air-conditioning: So that even splendidly hot summer become as unbearable as the downpours.
Overpriced hotels: The only European country with a higher rate of tax on hotel rooms is Denmark.
Licensing hours: Alcohol is in short supply after 11 p.m. even in 24-hour cities. [/INST] question: What do tourists complain most? | options: A: Poor service B: Poor public transport C: Rain D: Overpriced hotels | answer: C </s> |
<s>[INST] context: Progressive multifocal leukoencephalopathy: -
Progressive multifocal leukoencephalopathy is a progressive disorder cause by J.C. virus
The main cells affected in the disease are oligodendrocytes.
Since oligodendrocytes are concerned with myelination, progressive multifocal leukoencephalopathy is characterized by multifocal areas of demyelination of varying size distributed throughout the brain but sparing the spinal cord and optic nerves.
Pathology
Besides demyelination there are characterises cytological alterations in both astrocytes and oligodendrocytes: -
Astrocytes
Enlarged and contain, hyperchromatic, deformed and bizarre nuclei and frequent mitotic figures.
Oligodendrocytes
These have enlarged densely staining nuclei that contains virus inclusions formed by crystalline arrays.
Symptoms of progressive multifocal leukoencephalopathy: -
Visual defects (45%) → Homonymous hemianopia, Conjugate gaze abnormalities
Mental impairment (38%) → Dementia, confusion, personality changes
Weakness → Hemi or monoparesis and ataxia
Seizures (20%) → Speech defect aphasia, hemiparesis, ataxia
Focal neurological signs
Progressive multifocal leukoencephalopathy is predominantly seen in patients with immunosuppressive disorders
Most commonly associated conditions are: -
AIDS (80%)Q
Hematological malignancies (13%)
Transplant recipients (5%)
Chronic inflammatory disease (2%)
Prognosis of progressive multifocal leukoencephalopathy
In most cases, death occurs in 3-6 months from onset of neurological symptoms and even more rapidly in patients with AIDS unless aggressive interetruvial treatment is undertaken.
Diagnosis
MRI is used for the diagnosis of PML.
MRI is better than CT scan in the diagnosis of PML and is frequently used for the diagnosis of PML.
On MRI the lesion appears as multifocal asymmetric coalescing white matter located periventricular.
These lesions have increased signals on T2 and FLAIR images and decrease signal on T-weighted images.
PML lesions are classically nonenhancingQ.
Another important diagnostic tool in PML is the PCR ampli [/INST] question: Inclusions in oligodendrogliocytes is a feature of - | options: A: Creutzfeldt-Jakob disease B: CIDP C: HSV D: Progressive multifocal leukoencephalopathy | answer: D </s> |
<s>[INST] context: Cisplatin is an antineoplastic commonly used in the treatment of metastatic ovarian and testicular cancers, as well as advanced bladder cancer. This medication is associated with profound nausea and vomiting; in fact, it is considered to be one of the most emetogenic agents on the pharmaceutical market. The selective 5-hydroxytryptamine-3 (5-HT3) receptor antagonists are potent anti nausea and anti emetogenic agents indicated for prevention of nausea and vomiting associated with cancer chemotherapy. Examples of 5-HT3 receptor antagonists include ondansetron, granisetron, and dolasetron. Dimenhydrinate is an antihistamine with anticholinergic activity; it is indicated for the treatment of nausea and vomiting associated with motion sickness. Dronabinol is the principal psychoactive substance present in Cannabis sativa (marijuana). The mechanism of its antiemetic action is largely unknown; it is indicated for the treatment of severe nausea and vomiting when conventional therapies are ineffective. Metoclopramide is a prokinetic agent indicated for the treatment of gastroesophageal reflux disease and diabetic gastroparesis. Since this agent blocks dopaminergic receptors in the chemotrigger zone, it is also effective in the treatment of severe nausea and vomiting. [/INST] question: A 67-year-old woman is being treated for metastatic ovarian cancer with cisplatin and cyclophosphamide. To prevent nausea and vomiting, she is given an agent that selectively antagonizes 5-hydroxytryptamine-3 (5-HT3) receptors. Which of the following drugs is this patient most likely taking? | options: A: Dimenhydrinate B: Dronabinol C: Metoclopramide D: Ondansetron | answer: D </s> |
<s>[INST] context: (Herpes- Zoster) (52-Roxburg's 17th) (1182- CMDT-08)* Herpes simplex - manifest as acute gingivo-stomalitis, herpes labialis**, balanitis, vulvo-vaginitis, proctitis or kerato conjunctivitis* Intraepidermal vesicles around the mouth and lip (Type I) on the genitalia (Type II)* Herpes Zoster (Shingles) - Involvement of the branches of trigeminal ganglion, with lesions in the distribution of the maxillary, mandibular or ophthalmic sensory nerves as is involvement of dermatomes of the cervical and thoracic regions* H. Zoster affecting the opthalmic branch of the trigeminal nerve involving the right side of the forehead and eye and corneal ulcerations (.Hutchinson's sign)* The eruption consists of grouped tense vesicles or even bullae surrounded by a zone of erythema characteristically limited to a singe neural segment and is strictly unilateralMolluscum Contagiosum - transmitted by skin to skin contact* Typical lesion is a pink - coloured or skin coloured umbilicatedpapule** containing a greyish central plug, face and genital regions are commonly involved* A live attenuated VZV vaccine helps prevent herpes Zoster in persons 60 years and older [/INST] question: A 40 years males presented with painful vesicular lesion in the forehead extending to the eyelids. Diagnosis is | options: A: Herpes simplex B: Herpes-Zoster C: Coxschiae infection D: Molluscum contagiosum | answer: B </s> |
<s>[INST] context: Teeth are important. Strong , healthy teeth help you chew foods that help you grow. They help you speak clearly. And yes ,they help you look best. Here are some tips for you to take care of you teeth:
1. Brush your teeth the right way.
Brush your teeth at least twice a day - after breakfast and before bedtime. If you can, brush after lunch or after sweet snacks, too. Brush all of your teeth, not just the front ones. Spend time brushing teeth along the sides and back of your mouth. Spend at least three minutes each time you brush. Play a song you like to help pass the time. Get a new toothbrush every three months. When you buy toothbrush, be sure it has soft bristles .
2. Learn how to floss your teeth..
Flossing is a very important way to keep your teeth healthy. Food may hide between two teeth. Flossing can help get rid of it. You'll need to floss your teeth at least once a day.
3. Have good eating habits.
You need to be careful about what you eat and drink. Eating sugar is a major cause of tooth decay . Eat lots of fruits and vegetables and drink water instead of soda . [/INST] question: What is the major cause of tooth decay? _ | options: A: Not brushing teeth B: Not changing toothbrush C: Eating sugar D: Not flossing teeth | answer: C </s> |
<s>[INST] context: <p>The causes of hypocalcemia can be differentiated according to whether serum PTH levels are low (hypoparathyroidism) or high (secondary hyperparathyroidism). Although there are many potential causes of hypocalcemia, impaired PTH or vitamin D production are the most common etiologies . Because PTH is the main defense against hypocalcemia, disorders associated with deficient PTH production or secretion may be associated with profound, life-threatening hypocalcemia. In adults, hypoparathyroidism most commonly results from inadveent damage to all four glands during thyroid or parathyroid gland surgery. Hypoparathyroidism is a cardinal feature of autoimmune endocrinopathies ; rarely, it may be associated with infiltrative diseases such as sarcoidosis. Impaired PTH secretion may be secondary to magnesium deficiency or to activating mutations in the CaSR, which suppress PTH, leading to effects that are opposite to those that occur in FHH. Vitamin D deficiency, impaired 1,25(OH) 2 D production (primarily secondary to renal insufficiency), or vitamin D resistance also cause hypocalcemia. However, the degree of hypocalcemia in these disorders is generally not as severe as that seen with hypoparathyroidism because the parathyroids are capable of mounting a compensatory increase in PTH secretion. Hypocalcemia may also occur in conditions associated with severe tissue injury such as burns, rhabdomyolysis, tumor lysis, or pancreatitis. The cause of hypocalcemia in these settings may include a combination of low albumin, hyperphosphatemia, tissue deposition of calcium, and impaired PTH secretion. CLINICAL MANIFESTATIONS Patients with hypocalcemia may be asymptomatic if the decreases in serum calcium are relatively mild and chronic, or they may present with life-threatening complications. Moderate to severe hypocalcemia is associated with paresthesias, usually of the fingers, toes, and circumoral regions, and is caused by increased neuromuscular irritability. On physical examination, a Chvostek's sign (twitching of the circumoral muscles in response to gentle tapping of the facial nerve just anterior to the ear) may be elicited, although it is also present in ~10% of normal individuals. Carpal spasm may be induced by inflation of a blood pressure cuff to 20 mmHg above the patient's systolic blood pressure for 3 min (Trousseau's sign). Severe hypocalcemia can induce seizures, carpopedal spasm, bronchospasm, laryngospasm, and prolongation of the QT interval(harrison 18 pg 362)</p> [/INST] question: Features of hypocalcemia areA/E - | options: A: Numbness & tingling B: Circumoral paresthesis C: Depressed tendon reflexes D: Skin irritability & sensitivity | answer: C </s> |
<s>[INST] context: Those who spend more pre-bedtime hours using the Internet or watching television are more likely to report insufficient sleep, even though they sleep almost as long as people spending fewer pre-bedtime hours in front of a computer or television screen, survey findings show.
"While many people use electronic media, say, the Internet, it should be noted that the longer media use before sleep can trigger (self-perceived) insufficient sleep," lead researcher Dr Nakamori Suganuma, of Osaka University, Japan, told the reporter.
He and colleagues obtained data on self-perceived sleep problems and the use of electronic media prior to bedtime from 5,875 altogether Japanese respondents in two separate Internet-based surveys. Their findings are published in Sleep and Biological Rhythms.
Nearly half of the respondents associated their problem with electronic media use before bedtime. Longer electronic media users were also more likely to report insufficient sleep.
"Overall, 29% of light users (less than 1.5 hours) listed electronic media use as a possible cause of their insufficient sleep. By comparison, 40% of medium users (1.5 to 3 hours) and 54% of heavy users (more than 3 hours) said the same.
However, longer Internet and television use before bedtime did not _ less actual sleep.
While heavy users averaged about 3 more hours in front of computer or television screens than light users, the heavy users averaged only about 12 minutes less pre-workday sleep time than light users.
Notably, Suganuma said, "Internet use affected self-perceived insufficient sleep more than TV watching not only in younger Internet users but also in middle-aged or aged Internet users."
Up to 38% of the respondents listed accessing the Internet far into the night as a possible cause for their sleep disturbance, while about 25% said watching television far into the night caused it.
The findings suggest that while heavy computer and television use before bedtime has a small effect on sleep duration, it may have a more significant effect on "sleep demand and sleep quality," Suganuma notes. [/INST] question: Heavy computer and television user before bed time are more likely to be _ than light ones. | options: A: energetic B: happy C: sleepy D: clever | answer: C </s> |
<s>[INST] context: Good news! Job offered.
Receptionist Administration
Full Time
A receptionist is required from 1st June 2015 at Dartford Science & Technology College. The position is only from 8:30 am to 4:30 pm Monday to Thursday and 8:30 am to 4:00 pm Friday, with an hour's break for lunch every day. The successful applicant must have a good telephone manner, good interpersonal skills and IT skills.
Science Technician
Term time plus 10 days, 37 hours per week
We are looking for a technician to provide a technical support service for science teaching staff. Applications are to be received no later than midnight on 10thJune 2015.
Health & Social Care Teacher
Our client, an 11-18 mixed comprehensive school in Ealing, West London, is currently seeking a teacher for Health & Social Care. The position will be a full-time post until July 2015. We require an energetic teacher to develop the learning potential of students. We are seeking someone with excellent subject knowledge who can combine academic strictness and achievement with enjoyment of teaching Health & Social Care.
If you are keen to work, click the button below. [/INST] question: The receptionist to be employed will work _ . | options: A: 20 hours a week B: 37 hours a week C: 39.5 hours a week D: 34.5 hours a week | answer: D </s> |
<s>[INST] context: As the queen prepares to celebrate her Diamond Jubilee, one of her closest s and oldest friends has been allowed to give a deep description of the family life of the royals. There have been hundreds of other books declaring to offer a quick look behind the Palace doors, but this is the first written by someone who is closely related to the royal family and has shared their lives----not only throughout the Queen's reign but also through that of her father, King George VI.
The Final Curtseywas written by Her Majesty's cousin and childhood playmate, the Honorable Margaret Rhodes. It tells in detail the story of Mrs. Rhodes's relationship with the royal family over eight decades. The book, showed with delightfully informal and never-before-seen pictures, has been written with the full knowledge of the Queen, who has read and approved parts of it.
Mrs. Rhodes lives on the royal farm in Windsor Great Park, in a house given to her by the Queen in 1980. She tells how it was offered out of the blue one day when she and the Queen---whose 60 years on the throne next year will be marked with many national famous people---were out riding. She suddenly turned around and said, " Could you bear to live in the suburb?" Therefore Mrs. Rhodes is now still living here.
Born in 1925, the youngest daughter of the 16thLord Elphinstone and his wife Mary, the Honorable Margaret Rhodes has led an extraordinary life. She was the childhood playmate of her cousin, the Queen; she was a wartime MI6 spy; she was a lady-in-waiting to her aunt, Queen Elizabeth the Queen Mother, from 1991 until the latter's death in 2002. At the Queen's 80thbirthday in April 2006, Margaret gave an interview to the BBC in which she proved that, in her own opinion and despite several false reports, the Queen would not abdicate . Now, at the age of 86, she has written a charming autobiography that paints a first-time close portrait of the private world of the royal family.
Elsewhere in the book she reveals how the Queen Mother was a fan of the TV shows Two Fat Ladies and Dad's Army. Perhaps more surprisingly, she was also a fan of the poet Edith Sitwell and the Poet Laureate Ted Hughes, who was a regular and favoured guest.
Life at Birkhall, the Queen Mother's home of the edge of the Balmoral Estate, is described along with sometimes noisy dinners. Mrs. Rhodes recalls: "At the end of the meal, Queen Elizabeth would start a series of toasts. As well as 'Hooray for...' with glasses held high, there was even more of ' Down with...' with glasses almost disappearing beneath the table." [/INST] question: Compared with other books about the royal family, what is the biggest advantage of The Final Curtsey? | options: A: It predicts whether the Queen will leave the Palace B: Its author is the Queen's cousin who knows her well C: Its author presents readers a really different Queen D: It discloses when the Queen will retire to work on the farm | answer: B </s> |
<s>[INST] context: Transformation There is direct uptake of donor DNA by the recipient cell, which may be natural or forced. Transduction - donor DNA is carried in a bacteriophage and is transferred to the recipient by the mechanism used for phage infection , two type lytic and lysogenic Lysogenic conversion, bacteriophages exhibit two types of cycles, virulent or lytic cycle where the host bacterium is lysed and the temperate or nonlytic cycle where host bacterium is unharmed. Eg diphteria Conjugation- The donor cell contributes energy and building blocks to the synthesis of a new DNA strand, which is physically transferred into the recipient cell, usually by a tube called a sex pilus. Transferable drug resistance mediated by the R factor is the most impoant method of drug resistance Mutational resistance is of great impoance in tuberculosis. If a patient is treated with streptomycin alone, initially the appear and multiply unchecked. If two or more anti-re-population by resistant mutants does not occur, as a mutant resistant to one drug will be destroyed by the other drug. [/INST] question: DNA transfer in bacteria phage is: | options: A: Conjugation B: Transduction C: Transformation D: Translation | answer: B </s> |
<s>[INST] context: When you see homework covering the kitchen table and toys are piling up around the sofa,you probably wish there was a bit more space.You are not alone.Nearly a third of parents say they feel squeezed into their homes but cannot afford to move to a bigger property,a report reveals today.
Twenty--nine percent say 'their property is too small to fit the size of their family'--rising to 40 percent for those 34 and under.One in four children is 'forced to share' a bedroom,according to the Finda Property,com website.Property analyst Samantha Baden said:"Afford ability remains a key issue for families,with the average cost of a three-bedroom home around PS193,000."Very few can afford to buy--or to rent--a property of the size they want and in the area they desire to live in,according to Miss Baden.
A recent report,from investment firm LV,also found that many' space--starved parents' are pushed into a two--bedroom home which was perfect when they were a young couple,but has no space for three or so children.Grown--up children who cannot afford to leave home are also adding to the problem facing families in Britain's 'big squeeze'.
For a home to be the correct size, which means it is not overcrowded,parents must have their own bedroom.Children under ten can share, as well as same--sex children between ten and 20.Anyone over 21 also needs their own room.
The report comes as official figures,published yesterday by the Land Registry,revealing house prices are falling sharply in every region except London.The worst--hit area is the North East,where, average house prices have fallen to belowPS100,000 for the first time in seven years. However,they remain unaffordable for millions. [/INST] question: The report from the investment firm LV shows_. | options: A: young couples should live in a two--bedroom home B: families with three or so children couldn't afford a home C: parents should buy houses for their grown--up children D: some grown--up children couldn't afford a separate home | answer: D </s> |
<s>[INST] context: In ancient Greece,there were four major athletic meetings and the Olympian meeting played the most important part in the lives of the people. As time passed,the Olympian meeting gradually lost its local character and became first a national event and then international. No one knows exactly how far back the Olympic Games go but some official records date from 776 BC.
The Games took place every four years on the plain by Mount Olympus. Thousands of people came from all parts of the Greek world to watch the games. The winner of the foot race had the great honor of giving his name to the year of his history.
After a long history of almost 1,200 years,the Games were stopped for religious reasons. It was then decided in 1896 to start the Olympic Games again. The meeting was held in Athens and 311 athletes from 13 countries took part in it but the idea of such an international meeting attracted the world's attention. After the 1908 London Olympics,many nations sent their best athletes. Although the Games have been time and again threatened by some unfavorable political events, the Games have taken place every four years.
Nowadays, the Games are held in different countries in turn. As the biggest international gathering of any kind in the world,athletes from different countries play games together and this provides them with good chances to learn to live together. The friendly feelings in the Olympic Village make people think of the world as one big family. The Olympic Games will be hosted in Beijing in 2008. It is believed that the Games will be a wonder of the world. [/INST] question: The first old Olympic Games took place _ . | options: A: a thousand years ago B: in the seventh century AD C: in modern times D: before 700 BC | answer: D </s> |
<s>[INST] context: High in the mountains, and deep in the forest, lives a lake with many plants and animals in and around her. The plants and animals have enough food and clean water to keep them healthy. The wind carries
air, and the rain comes down clear and clean.
But recently, Lucy Lake and her friends haven't been feeling very well. All the plants and animals get together to talk about the problem. "Why are we sick?" "What can we do?" ask all of them. No one has any answers.
Just then two hikers appear. The animals tell them about their problems. "Can you help us?" they ask. "Yes," one hiker says. "I think it's because of acid rain."
"Acid rain comes from chemicals in the air. The pollution comes from factories, cars and trucks."
"So, although I don't want to, I help the pollution travel through the air!" says the wind. "And I carry it to the land!" cries the rain.
"If you can help us think of some solutions , we will send a message to tell people how to clean up our environment," one hiker says.
With the help of the plants and animals, the two hikers make a list of ideas for saving Lucy Lake and her friends.
Time passes, and the forest and lake begin to feel a little better.
The next time the hikers climb up the mountains to Lucy Lake, they smile at what they find. "We're glad things have started to change," one hiker says. "And we're glad
helped us make a difference," says the other. [/INST] question: The two hikers are most probably _ . | options: A: scientists B: teachers C: doctors D: reporters | answer: A </s> |
<s>[INST] context: Alexander the Great was a mighty king and conqueror . He was one of the greatest military geniuses the world has ever known. He was born in Pella, Macedonia. Alexander grew to be a handsome, brilliant man. Aristotle, the famous philosopher , came from Greece to teach him---geography, politics, literature, medicine and science. Alexander's father, King Philip II of Macedon, taught him to plan and win battles.
The young prince became King when he was 20. He then began the series of marches that continued until he ruled almost all of the then-known world. On his great war horse, Bucephalus, he first took over Greece. He went on to conquer southeastern Europe, Asia Minor, Egypt and India. On his way he crushed the Persian Empire, and was made King of Egypt and Asia. He and his troops traveled over 11,000 miles(17,700 km). He spread Greek customs and ideas wherever he went.
In India his men refused to go further. They were tired and frightened, and wanted to go home. Worn out, Alexander agreed to turn back. He died of fever in Babylon, at the early age of 33. [/INST] question: Alexander and his troops traveled and fought probably _ then. | options: A: by ship B: by simple truck C: on their horses D: on foot | answer: C </s> |
<s>[INST] context: ** Intraosseous (IO) access was initially thought to be less applicable in patients older than 6 years, now there is growing suppo for consideration of IO techniques in patients of any age as rapid and equally effective alternatives to intravenous (IV) peripheral lines. Intraosseous infusion (IO) is the process of injecting directly into the marrow of a bone to provide a non-collapsible entry point into the systemic venous system.This technique is used in emergency situations to provide fluids and medication when intravenous access is not available or not feasible. A comparison of intravenous (IV), intramuscular (IM), and intraosseous (IO) routes of administration concluded that the intraosseous route is demonstrably superior to intramuscularand comparable to intravenous administration (in delivering paediatric anaesthetic drugs).Due to the rapid advance and adoption of superior intraosseous access technology, IO access has now become the preferred method of establishing vascular access for patients in whom traditional access is difficult or impossible. [/INST] question: In pediatric advanced life suppo, intraosseous access for drug/fluid administration is recommended for | options: A: <1yr B: <6 yrs C: <12yrs D: Any age | answer: B </s> |
<s>[INST] context: "Regardless of social class, race, age, men say they hate to shop," says Zukin, City University of New York sociology professor. " Yet when you ask them deeper questions, it turns out that they like to shop. Men generally like to shop for books , music and hardware. But if you ask them about the shopping they do for books or music, they'll say, ' Well , that's not shopping. That's research .'"
In other words, what men and women call "buying things" and how they approach that task are different.
Women will wander through several 1,000-square-meter stores in search of the perfect party dress. Men will wander through 100 Internet sites in search of the perfect digital camcorder.
Women see shopping as a social event. Men see it as a special task or a game to be won.
"Men are frequently shopping to win," says Ann, a marketing professor at Loyola University of Chicago. "They want to get the best deal. They want to get the best one, the latest one and if they manage to do that it makes them happy."
"When women shop, they're doing it in a way that they want everybody to be very happy," says Ann. "They're kind of shopping for love."
"Teenage girls learn to shop from their moms and older sisters, but they also learn to shop by examining articles in magazines like Seventeen." Zukin says.
"And although men's magazines such as GQand Esquire have long had shopping articles, it's TV that has the eye of young male shoppers," says Ann and Zukin.
"Of course, there are men who love to shop and are proud of it," Loyola's Ann says.
And that is important no matter whether you buy a car or a frying pan. All men love to buy but they don't want to be cheated.
Ann adds, "There actually are men who are interested, for example, in cooking or shopping or chinaware or things around their homes--they become kind of girl magnets. Women like it. " [/INST] question: Compared to women , men usually treat shopping as _ . | options: A: a social event B: a task C: a TV game D: entertainment | answer: B </s> |
<s>[INST] context: Methyl ergometrine Cardiac patients' should not receive ergotamine because these agents cause significant vasoconstriction and elevation of blood pressure which can be deleterious to the patient. Also know, In healthy women, an intravenous bolus of 10 units of oxytocin caused a transient but marked fall in aerial blood pressure that was followed by an abrupt increase in cardiac output. These hernodynamic changes could be dangerous to women already hypovolemic from hemorrhage or who had cardiac disease that limited cardiac output. The same danger is present for women with right to left cardiac shunts because the decrease in systemic resistance would fuher increase the shunt. So, - Oxytocin should not be given intravenously as a large bolus, but rather as a much more dilute solution by continuous intravenous infusion or as an intramuscular infection. Management of cardiac patient during pregnancy Antepaum Bed rest The most impoant measure for attenuating the impact of pregnancy on diseased hea is bed rest. Bed rest increases the venous return to the hea, improves renal perfusion, induces diuresis and promotes elimination of water. Dietory salt restriction It helps to prevent excess retention of sodium and water. Diuretics It should be given to cardiac pregnant patient if moderate restriction in sodium intake is insufficient to limit the normal intravascular volume expansion that occurs during gestation. Prophylactic digitalization It is commonly used in patients with severe hea disease who are not in ove congestive failure. During labour and delivery The pregnant cardiac patient should always labor and deliver in lateral supine position to avoid hemodynamic impairment caused by dorsal decubitus position. Effective pain relief during labour with morphine. Continuous monitoring with pulse oximetry. Restriction of i.v. fluids to 75 ml/hr (Almost all cardiac patients in labour should be kept on the dry side). Antibiotic prophylaxis (This is given in patients with congenital or acquired hea lesions). Thrombosis prophylaxis. Patient should be placed in sitting position after delivery. This is done to avoid pulmonary edema (sitting will increase venous pooling in the lower extremities and decrease the venous return to the hea). [/INST] question: Drug contraindicated in patient with rheumatic hea disease in PPH is | options: A: Oxytocin infusion B: Methyl ergometrine C: Misoprostol D: Carboprost | answer: B </s> |
<s>[INST] context: Jean is a bright young lady who comes from a rich and famous family. She goes to a good university and has everything that money can buy. Well, almost everything is good. But the problem is that Jean's family are so busy that they can hardly find time to be with her. So Jean spends a lot of time on her QQ. She likes being anonymous , talking to people who do not know about her famous family and her rich life. She uses the name Linda on QQ and has made a lot of friends who she keeps in touch with quite often.
Last year Jean made a very special friend on QQ. His name was David and lived in San Francisco. David was full of stories and jokes. He and Jean had a common interest in rock music and modern dance. So it always took them hours to talk happily on QQ and sometimes they even forgot their time. Of course, they wanted to know more about each other. David sent a picture of himself: He was a tall, good looking young man with big, happy smile. As time went by, they became good friends and often sent cards and small things to each other.
When Jean's father told her that he was going on a business trip to San Francisco, she asked him to let her go with him so that she could give David a surprise for his birthday. She would take him the latest DVD of their favorite rock singer. But when she knocked on David's door in San Francisco, she found that her special friend was a twelve-year-old boy named Jim! [/INST] question: Jean spends a lot of her time on QQ because she is _ . | options: A: rich B: young C: lonely D: talkative | answer: C </s> |
<s>[INST] context: Today, there's hardly an aspect of our life that isn't being upended by the tons of information available on the hundreds of millions of sites crowding the Internet, not to mention its ability to keep us in constant touch with each other via electronic mail. "If the automobile and aerospace technology had exploded at the same pace as computer and information technology," says Microsoft, "a new car would cost about $ 2 and go 600 miles on a small quantity of gas. And you could buy a Boeing 747 for the cost of a pizza."
Probably the biggest payoff, however, is the billions of dollars the Internet is saving companies in producing goods and serving for the needs of their customers. Nothing like it has been seen since the beginning of the Industrial Revolution, when power-driven machines began producing more in a day than men could turn out in nearly a year. "We view the growth of the Internet and e-commerce as a global trend," says Merrill Lynch, "along the lines of printing press, the telephone, the computer, and electricity."
You would be hard pressed to name something that isn't available on the Internet. Consider: books, health care, movie tickets, construction materials, baby clothes, stocks, cattle feed, music, electronics, antiques, tools, real estate, toys, autographs of famous people, wine and airline tickets. And even after you've moved on to your final resting place, there's no reason those you love can't keep in touch. A company called FinalThoughts.com offers a place for you to store "afterlife e-mails" you can send to Heaven with the help of a "guardian angel".
Kids today are so computer literate that it in fact ensures the United States will remain the unchallenged leader in cyberspace for the foreseeable future. Nearly all children in families with incomes of more than $75,000 a year have home computers, according to a study by the David and Lucile Packard Foundation. Youngsters from ages 2 to 17 at all income levels have computers, with 52% of those connected to the Internet. Most kids use computers to play games (some for 30 hours or more a week), and many teenage girls think nothing of rushing home from school to have e-mail chats with friends they have just left.
What's clear is that, whether we like it or not, the Internet is an ever growing part of our lives and there is no turning back. "The Internet is just 20% invented," says cyber pioneer Jake Winebaum. "The last 80% is happening now." [/INST] question: What can we learn from the Microsoft's remark? | options: A: Information technology is developing at an amazing speed B: Today's cars and airplanes are extremely overpriced C: Information technology has reached the point where improvement is difficult D: There's more competition in information technology industry than in car industry | answer: A </s> |
<s>[INST] context: Takayasu arteritis
Takayasu arteritis is granulomatous vasculitis of large and medium arteries.
It is characterized principally by ocular disturbance and marked weakening of pulses in the upper extremities Pulseless disease.
It is also characterized by a strong predilection for aortic arch and its branches → Aortic arch syndrome.
It is more common in Adolescent girls and young women.
Morphological changes in vessel wall are same as in giant cell arteritis.
Clinical presentation
Symptoms are mainly according to the involved vessel -
C Subclavian artery :
Most commonly involved vessel
Symptoms are - Arm claudication, lower BP and weaker pulse in upper limb than in lower limb, Raynaud's phenomenon.
Common carotid → Visual disturbances, stroke, TIA, syncope.
Abdominal aorta or coeliac artery or superior mesenteric artery → Abdominal pain, nausea, vomiting
Renal → Hypertension, Renal failure
Aortic root → Aortic regurgitation, CHF
Vertebral → Visual disturbances
Iliac → Leg claudication
Pulmonary → Pulmonary hypertension, dysnea, chest pain.
Coronary → Angina, MI
Constitutional symptoms → As with other vasculitis malaise, fatigue, anorexia and weight loss are common.
Elevated ESR and Anemia (as with other vasculitis) [/INST] question: The pulseless disease is - | options: A: Giant cell arteritis B: Takayasu arteritis C: Kawasaki disease D: Polyarteritis nodosa | answer: B </s> |
<s>[INST] context: The primary role of altered metabolism during fasting is to maintain blood glucose through the synthesis (gluconeogenesis) and utilization of alternate substrates. Fasting-starvation is divided in three broad categories:?Initial stage :- Lasts upto 2-3 daysIntermediate stage :- Lasts upto 24 daysAdvanced stage:- begins after 24 days.a) Initial stage (first stage):- Liver glycogen is the first main provider of energy. But due to limited storage it can not last longe (16-18 hrs.). Fuher glucose is provided by gluconeogenesis by non-carbohydrate sources (muscle protein breakdown is increased which provides amino acids alanine and glutamine for gluconeogenesis). Utilization of alternate substrates (other than glucose) stas increasing in terminal period of this stage. Free fatty acids and ketone bodies sta rising in this stage. Glycogen is completely depleted by the end of this stage. Blood glucose is slightly decreased.The first priority of metabolism in starvation is to provide sufficient glucose to brain and other tissues that are absolutely dependent on glucose.Liver glycogen provides glucose only for a sho period. Whereas, gluconeogenesis plays an essential role in maintaining blood glucose during both sho-term and prolonged starvation.The substrate for gluconeogenesis are pyruvate, lactate (from RBCs and exercising muscles), glucogenic amino acids released from muscle protein breakdown, and glycerol released from lipolysis.b) Intermediate stage (Second stage):- Free fatty acids are the major substrates for energy production. They are derived from hydrolysis of fat (triglycerides) in adipose tissue. Ketone bodies serve as additional source of energy. As glycogen source is already depleted, the only source of glucose is increased gluconeogenesis. After sometimes muscle breakdown decreases due to decreased need of glucose as a fuel for brain which has began using ketone bodies as a source of energy.c) Advanced stage (Third stage):- When fat stores are almost exhaused, energy requirment is obtained from breakdown of tissue proteins and protein stores once again enter in stage of rapid depletion.Thus the second priority of metabolism in starvation is to preserve protein. This is accomplished by using fatty acids and ketone bodies in place of glucose as a fuel. [/INST] question: In how much time does Hepatic glycogen storage depletes during starvation? | options: A: 18 hrs B: 36 hrs C: 72 hrs D: 48 hrs | answer: A </s> |
<s>[INST] context: This busy and popular hotel requires a Junior Chef. You will need to be energetic, enthusiastic with a minimum of five years' kitchen experience. You must assist the head and senior chefs in the creation of new dishes. Annual salaries range from 20,000 to 25,000 pounds. Please send or e-mail your CV to the Personnel Administrator Hydo Hotel, Mount Road Eastbourne BN207HZ [email protected].
We are looking for a kitchen assistant willing to learn the day-to-day jobs in a professional kitchen environment. You must have a passion for cooking and basic understanding of spoken English. You will mainly be working for a well-known company and learn valuable cheffing skills. The salary will be based on experience but could start from 12,500 pounds to 14,000 pounds annually plus tips. Please forward your CV and a letter of recommendation.
01428644460
Kitchen Manager. Spirit Pub Company is looking for the best individuals to lead our kitchen teams through some very exciting new developments. As an experienced Kitchen Manager, you will play an important role in engaging the chef team by great leaderships to deliver excellent standards and guest satisfaction. We can offer a starting salary of up to 27,000 pounds plus a bonus worth an extra 2,000 pounds per year for the right candidates. If you have what it takes to join our company, please provide your CV with your application.
07044338313
Food Service Assistant, South East Food Service Assistant required. Salary starts from 15,000 pound to 20,000 pounds annually. We are seeking a General Assistant for a Care Home East Sussex. Assisting the Cook and kitchen team in the food preparation of freshly prepared meals, washing up and cleaning of all kitchen areas. Previous experience would be an advantage.
07044338228 [/INST] question: Which job probably offers the second highest salary? | options: A: Kitchen manager B: Kitchen assistant C: Food service assistant D: Junior chef | answer: D </s> |
<s>[INST] context: It's so beautiful outside that spending the day in the office would be very boring. So why not take the vacations off? A new survey found that 31%of U.S workers don't always take all of their vacation days. Americans have 12 vacation days on average each year, but they give back an average of 3 vacation days each year.
So why don't they use up their vacation days? Some say they would rather get money back for their unused days; some busy workers say they just can't leave their work. Americans have fewer vacation days than workers in any other country surveyed.
The French take their vacations seriously. French workers get an average of 39 vacation days, and 40% plan to take at least one there-to-four-week vacation.
Workers in Sweden receive an average of 25 vacation days a year, but they can't find time to use them all. More workers there return vacation days than any other country surveyed.
British workers have the longest working week in Europe ,with 23 vacation days --the shortest vacation. So they feel overworked.75% say their weekends or vacations are too short and 40% would _ a day's pay for one more vacation day. [/INST] question: _ U.S workers don't always take all of their vacation days. | options: A: All B: Most C: Some D: Few | answer: D </s> |
<s>[INST] context: Guide dogs help blind people who cannot get around by themselves.Although Yorkshire terriers and poodles are good companion dogs,guide dogs are chosen from lager breeds such as German shepherds,golden retrievers,and Labrador retrievers.The young dogs are raised by families until they are eighteen months old.During this time,they get lots of love and attention,but they are also taught to obey.Then the dogs go to a special school where,for four months,they work with a sighted trainer,an individual who can see.The dog forms a close relationship with this person who teaches it how to follow directions such as right,left,straight ahead,and stop.The young dog also learns to watch out for dangerous traffic and wait until it is safe to cross a busy street.
When the dog is two years old,it starts training with the blind person it will live with. The dog and its new owner make many trips from downtown to where the blind person lives so the dog becomes familiar with the normal atmosphere.During the training,a sighted trainer always remains with them. A blind person who is getting a guide dog for the first time will train for about a month. If the individual has had a dog before,the training takes about three weeks.After the training,the blind person depends on the guide dog for between seven and twelve years.At that point,the working dog become a family pet and the owner needs to train with a younger guide dog. [/INST] question: Which breed would NOT be trained as a guide dog? | options: A: A Yorkshire terrier B: A golden retriever C: A German shepherd D: A Labrador | answer: A </s> |
<s>[INST] context: Do your parents ever say, "act like a lady" or "be a gentleman" to you? But in the eyes of today's teenagers , what should a lady or a gentleman be like? Let's take a look.
What is a gentleman? The girls have their ideas:
Huang Xiaoyu of Guizhou: A gentleman doesn't always get angry . He wants others to be well and happy. He is always ready to help. There is a boy in my class and I think he is a gentleman. If I don't do well in the English exam, he will say, "You will do better next time." That makes me feel happy.
Chen Tingting of Shenzhen: A gentleman always says, "Ladies first" When students clean up the classroom, he does the heavy work. He lets girls go into rooms first. There are no gentlemen in my class. When there is something to eat, the boys in my class always get them before girls!
What is a lady? Boys tell us what they think a lady is:
Wu Yifan of Dalian: A lady is quiet and kind, but she's not shy and she can talk about her ideas in front of others. To me, Dong Jie, a film star, is a lady. She is pretty and kind. She does a lot for others.
Wang Lichao of Tianjin: A lady is not just beautiful but clever. She never says bad words. She is quiet and kind to others. I don't think there is a lady in my class. Most of the girls are "
", I think. [/INST] question: A gentleman doesn't _ . | options: A: think about others B: always say "ladies first C: do the heavy work D: get angry easily | answer: D </s> |
<s>[INST] context: This patient's history suggests pheochromocytoma. This rare (but often considered diagnostically) tumor is most often found in the adrenal medulla, although it can also be found in other tissues derived from neural crest cells. The tumor cells secrete catecholamine hormones or their precursors, which can cause either paroxysmal (as in this case) or persistent hypeension. Urinary metabolites of epinephrine and norepinephrine are vanillylmandelic acid (VMA) and homovanillic acid, so screening 24 hour urine collections for these substances can be helpful in establishing or excluding these diagnoses even in cases in which a physician does not observe one of the paroxysms and thus blood cannot be drawn for serum catecholamine levels at that time. DHEA is the adrenal androgen dehydroepiandrosterone (made by the adrenal coex rather than the adrenal medulla), and is measured in serum in cases where adrenal virilism is suspected. hCG is human chorionic gonadotropin, and both serum and urine levels can increase in pregnancy or trophoblastic disease. 17-ketosteroids are measured in urine during evaluation of congenital adrenal hyperplasia (a disorder of the adrenal coex rather than medulla).. [/INST] question: A 50-year-old man consults you because he has been having transient periods of rapid hea beat accompanied by sweating, flushing, and a sense of impending doom. Examination is unrevealing, with no evidence of arrhythmia at the time of the exam. However, the man&;s wife is a nurse, so the physician asks that she take vital signs the next time one of the episodes occurs. She does, and demonstrates a BP of 195/140 with hea rate 160/min during the episode. She promptly brings him to you, but the spell is over by the time that he is seen. Urinary measurement of which of the following would most likely be diagnostic in this case | options: A: Dehydroepiandrosterone (DHEA) B: Human chorionic gonadotropin (hCG) C: 17-ketosteroids D: Vanillylmandelic acid VMA | answer: D </s> |
<s>[INST] context: According to an English newspaper, scientists could begin cloning human embryos in Britain in 2001. It is understood that the government has already agreed to use Frankenstein's technology, believing the benefits are more important than ethical concerns .Researchers think it will be possible to grow brain tissue to cure the diseases that are likely to get worse as time passes like Alzheimer's , and produce "spare part" organs like hearts and kidneys for transplant .
Ministers are aware that the change in the law will be as controversial as the law which legalized abortion more than 30 years ago. Some politicians reacted angrily , arguing that the government had already made up its mind without discussion. Church leaders and anti-abortion campaigners have long expressed their horror at the plans, arguing that even the earliest embryos are forms of human life.They believe that getting an embryo from cells is morally unacceptable . And it will also cause arguments about how far scientists should interfere with nature and lead to accusations that _ are "playing God".
The cloning of human embryos to provide spare parts is regarded by most experts to be the most important step forward in the 21stcentury medicine. Scientists say treatment of diseases such as Alzheimer's and Parkinson's will be the first application of cloning. The ability to clone embryos was first achieved by scientists in Scotland in the late 1990s and now the ability to grow stem cells into tissues and organs is being developed by American researchers. Combining the two technologies will mean an end to long waits for organs from donors and problems caused by rejection of transplanted tissues by the body.
Ian Wilmut, the man who cloned Dolly the sheep, has warned that British experts will go to America, where such work is legal, if the government does not permit it. [/INST] question: The government has decided to allow scientists to clone human embryos because they think that _ . | options: A: Frankenstein's technology is advanced B: Its advantages are more important than its disadvantages C: Diseases like Alzheimer's are a serious problem in their country D: They can make a lot of money from it | answer: B </s> |
<s>[INST] context: Oyster
What is an Oyster card?
Oyster is the easiest way to pay for journeys on the bus,Tube,tram,Docklands Light Railway (DLR), London Overground and National Rail journeys in London You can store your travel cards, Bus & Tram Pass, season tickets and credit to pay for journeys as you go.
Where to get an Oyster card?
There are a number of ways for you to get an Oyster card:
* At over 3,900 Oyster Ticket stops
* At Tube and London Overground station ticket offices
* At some National Rail stations
* At London Travel information Centres
* Online at tfl. gov. uk/oyster
How to use an Oyster card?
To pay the correct fare on the Tube , DLR, London Overground and National Rail services, you must always touch in on the yellow Oyster card reader at the start of your journey, and touch out at the end. If you don't, a maximum cash Oyster fare will be charged. When using the bus or tram, you must only touch in at the start, but not at the end of your journey.
What happens if I don't visit London very often?
Don't worry. Any pay as you go credit on your card will not expire ,so you can keep it for your next visit or lend it to a friend.
Fares
Traveling by Tube from Central London (Zone l)to Heathrow (Zone 6)
Adult Oyster single fare
PS 4. 20 Monday to Friday 06:30 - 09:30 and 16:00 - 19:00
PS 2. 70 at all other times including public holidays
Adult single cash fare PS 5.00
For further information,visit tfl.gov. uk /fares. [/INST] question: You can get an Oyster card at the following places EXCEPT _ . | options: A: on the website B: at an Oyster Ticket stop C: at a post office D: at a Tube station | answer: C </s> |
<s>[INST] context: In children, ITP is the most common form of thrombocytopenic purpura. In most cases, a preceding viral infection can be noted. No diagnostic test identifies this disease; exclusion of the other diseases listed in the question is necessary. In this disease, the platelet count is frequently less than 20,000/mL, but other laboratory tests yield essentially normal results, including the bone marrow aspiration (if done). Complications are uncommon; significant bleeding occurs in only 5% of cases and intracranial hemorrhage is even rarer. The treatment of childhood ITP is controversial. Patients with mild symptoms such as bruising and self-limited epistaxis may be observed, while patients with significant bleeding should be treated. IVIG and corticosteroids are effective in causing a rapid increase in platelet count, but controversy exists surrounding the use of prednisone before ruling out leukemia with a bone marrow aspirate. For Rh-positive patients with a working spleen, the use of anti-D immunoglobulin also results in an increase in platelet count. For patients with chronic (> 1 year) ITP, a splenectomy may be necessary.Aplastic anemia is unlikely if the other cell lines are normal. vWD might be expected to present with bleeding and not just bruising. It is unlikely that acute leukemia would present with thrombocytopenia only. Thrombotic thrombocytopenic purpura is rare in children. [/INST] question: Two weeks after a viral syndrome, a 2-year-old child develops bruising and generalized petechiae, more prominent over the legs. No hepatosplenomegaly or lymph node enlargement is noted. The examination is otherwise unremarkable. Laboratory testing shows the patient to have a normal hemoglobin, hematocrit, and white blood cell (WBC) count and differential. The platelet count is 15,000/mL. Which of the following is the most likely diagnosis? | options: A: Von Willebrand disease (vWD) B: Acute leukemia C: Idiopathic (immune) thrombocytopenic purpura (ITP) D: Aplastic anemia | answer: C </s> |
<s>[INST] context: Melbourne, with a population of over 3.5 million, is the second largest city in Australia. It is clean, safe, dynamic and exciting, and well known internationally for its universities and other educational institutions. The city has well-planned tree-lined wide streets and many beautiful parks and gardens. It has a good transport system of roads, buses, trains, and trams. The La Trobe University campus is connected to the Central Business District by trams, express buses, and bus and train connections. Melbourne is a culturally rich city, and is home to large communities of people from all parts of Europe, the Americas, Africa, and Asia. The city is famous for its restaurants, theatres, music, opera, ballet, art, culture, and shops, and a lively and dynamic nightlife. Melbourne people are fond of sports, and the city hosts many famous international sports events. Near Melbourne there are beautiful coastlines with excellent beaches, national parks, forests, wineries , winter snowfields and summer resorts. The climate is _ and comfortable, with warm summers and cool winters. In summer, maximum daytime temperatures range from 26degC to 36degC, and in winter from 12degC to 18degC. The weather in Melbourne can be variable from day to day. Melbourne was rated the world's best city to live in by the Economist Intelligence Unit. [/INST] question: Melbourne is well-known in the world for its _ . | options: A: large population B: educational institutions C: transport system D: beautiful parks and gardens | answer: B </s> |
<s>[INST] context: Huang Naihui was born in 1964 in Taipei. When he was a child, he had a very high fever, which made him partially paralyzed.
His parents were afraid that he would bring bad luck to the family and abandoned him. But his grandmother brought him up. It was at the age of 13 that he went to school. At the age of 22, he would study and work part-time. He would sell flowers during the day and attend classes at night. During his spare time he would study. The learning made him very happy.
He used his knowledge very well in his business of selling flowers. He would go door to door selling flowers during the day. He would sell flowers at pubs and night clubs at night. At times, in order to sell, he had to sing. He was often tricked. However, he would face the next customer with a smile. His grandmother passed away when he was 24. It was the darkest day of his life.
Today Huang Naihui owns 3 flower shops and employs disabled people to work for him. He would spend his spare time doing charity work. His book Facing the sun and his story have encouraged many people.
,. [/INST] question: What made Huang Naihui disabled? | options: A: A high fever B: The hot weather C: The hunger D: The cold | answer: A </s> |
<s>[INST] context: Ice Hotel Quebec, located 30 minutes west of Downtown Quebec City, Canada, is only open during the winter season. The hotel is made entirely of ice. The two galleries at the Ice Hotel Quebec feature events such as ice painting and ice sculpture competitions.
Things to Do
Guests have a choice of different winter vacation activities, including cross-country skiing, ice skating, dog sledding , ice fishing and sliding . Ice Hotel Quebec has a sauna( ),so remember to pack your bathing suit.
Rooms & Suites
The hotel offers 18 rooms and 14 theme suites built from 12,000 tons of snow and 400 tons of ice. The walls at Ice Hotel Quebec are four feet thick and allow the hotel to keep a temperature of -2degC to -5degC.
The furniture at the hotel is made of snow and ice, including the beds. The beds are equipped with a thick foam mattress and an extra thick sleeping bag. That is enough to prevent you from catching a cold.
Vacation Tip
Ice Hotel Quebec offers 30-minute guided public tours daily from 10:30am to 4:30pm. It costs $15 CAD for adults, $7.5 for children (under eight), $13for students\seniors (above sixty), and $42 for families.
Plan This Vacation
Ice Hotel Quebec-Canada will be open for its sixth season from January 5thto April 1st. Costs for overnight stays start at $199CAD per person.
If you're looking for something really different to do on your next trip, think creatively and plan to visit the truly unusual Ice Hotel Quebec! [/INST] question: If you visit the Ice Hotel, you can enjoy the following EXCEPT _ . | options: A: going fishing B: going skating C: appreciating ice sculptures D: holding an ice party | answer: D </s> |
<s>[INST] context: The old lady got up early to be ready for the post.Although she seldom received letters or parcels,today she was sure there would be something.Myra wouldn't forget her mother's birthday, even if she seldom wrote at other times.Of course Myra was busy.Her husband had been made Mayor, and Myra herself had got a medal for her work for the aged.
The old lady was eighty today.She had put on her best dress.Perhaps Myra might come.The old lady was sure of that.Two spots of color brightened her cheeks.She was excited--like a child.She would enjoy her day.
Mrs. Morrison,a social worker,had brought a card and a bunch of flowers when she came to do the breakfast.Mrs. Grant downstairs had made a cake.The little boy from the ground floor,Johnnie,had been up with a packet of candies,and offered to help her fetch the post.
"I guess you'll get lots and lots of presents,"he said,I did last week when l was six."
What would she like ? A pair of slippers,a table lamp,a book or a little clock.So many lovely things.
She stood by the window,watching.The postman turned round the corner on his bicycle.Her heart beat fast.Johnnie had seen him too and ran to the gate.And then he gave her four envelopes.Three were unsealed cards from old friends.The fourth was sealed,in Myra's writing.
"No parcel,Johnnie?"
"No,granny."
Maybe the parcel was too large to come by letter post.That was _ .It would come later by parcel post.She must be patient.
But disappointment flooded her.She tore the envelope open unwillingly.A cheque fell to the floor like a bird with a broken, wing.Slowly the old lady bent to pick it up.With trembling fingers she tore it into little bits. [/INST] question: What kind of work did Myra probably take? | options: A: charity B: paperwork C: accounting D: education | answer: A </s> |
<s>[INST] context: The most commonly repoed ADRs are oral dryness, ocular hyperaemia and burning/stinging, all occurring in 22 to 25% of patients. They are usually transient and not commonly of a nature serious enough to require discontinuation of treatment. Symptoms of ocular allergic reactions have been repoed to have occurred in 12.7% of subjects in clinical trials (causing withdrawal in 11.5% of subjects), with onset being between 3 and 9 months in the majority of patients. The following convention has been used for classification of frequency of undesirable effects: Very common : >=1 in 10. Common : >=1 in 100 and <1 in 10. Uncommon : >=1 in 1,000 and <1 in 100. Rare : >=1 in 10,000 and <1 in 1,000. Very rare : < 1 in 10,000. Not known (cannot be estimated from the available data) Within each frequency grouping, undesired effects are presented in order of decreasing seriousness. Cardiac disorders: Uncommon: Palpitations/arrhythmias (including bradycardia and tachycardia). Nervous system disorders: Very common: Headache, drowsiness. Common: Dizziness, abnormal taste. Very rare: Syncope Eye disorders: Very common : Ocular irritation including allergic reactions (hyperaemia, burning, stinging, pruritis, foreign body sensation, conjunctival follicles); blurred vision, allergic blepharitis, allergic blepharoconjuctivitis, allergic conjunctivitis, ocular allergic reaction and follicular conjunctivitis. Common: Local irritation (eyelid hyperaemia and oedema, blepharitis, conjunctival oedema and discharge, ocular pain and tearing); photophobia; corneal erosion and staining; ocular dryness; conjunctival blanching; abnormal vision; conjunctivitis. Very rare : Iritis (anterior uveitis); miosis. Respiratory, thoracic and mediastinal disorders: Common: Upper respiratory symptoms. Uncommon: Nasal dryness. Rare: Dyspnoea Gastrointestinal disorders: Very common: Oral dryness. Common: Gastrointestinal symptoms. Vascular disorders: Very rare: Hypeension, hypotension. General disorders and administration site conditions: Very common: Fatigue. Common: Asthenia. Immune system disorders: Uncommon: Systemic allergic reactions. Psychiatric disorders: Uncommon: Depression. Very rare: Insomnia. The following adverse reactions have been identified during post-marketing use of Brimonidine eye drops in clinical practice. Because they are repoed voluntarily from a population of unknown size, estimates of frequency cannot be made. Not known: Eye disorders Iridocyclitis (anterior uveitis) Eyelid pruritus Skin and subcutaneous tissue disorders Skin reaction including erythema, face oedema, pruritus, rash and vasodilation [/INST] question: Which of the following antiglaucoma medications can Cause drowsiness? | options: A: Latanoprost B: Timolol C: Brimonidine D: Dorzolamide | answer: C </s> |
<s>[INST] context: Tony is reading an advertisement in a magazine. It is about different evening classes or weekend classes.
The Learning Centre, Garden City
We have evening and weekend courses on ...
test preparation friends and meeting people
jobs and making money cooking and language learning
Some of this month's courses:
1. Get good grades!
Do you forget information and do poorly on tests? In this course, learn to...
* remember more (95 percent of what you read).
* think quickly and read fast (400 words per minute!).
* do well on tests and get high scores.
2. Find true love...today!
Are you single and shy? Is it hard for you to talk to people?
In this course, learn to...
talk to people; start a conversation with a man or woman.
be more friendly and outgoing.
* understand a person's body language.
3. You are on TV!
Many actors get their start in television. You can too! In this course, learn to...
* act in TV ads.
* use your voice on the radio.
* get TV and radio jobs.
4. Cook delicious and healthy food!
Are you interested in cooking? Do you want to keep healthy? In this course, learn to...
* keep a balanced diet.
* cook delicious traditional Chinese food.
* make western-style food. This course is also online al www. dffh. net. cn. [/INST] question: In the Learning Center, you won't learn how to _ . | options: A: prepare for a test B: make money C: learn a language D: get along well with others | answer: D </s> |
<s>[INST] context: Sydney is a young city. Its history goes back just over 200 years. But in Australia, it is the oldest city. It is also the country' s largest city. Sydney is the capital of New South Wales and the most popular city of Australia.
The climate of Sydney is very good. It' s not too cold during the winter and not too hot during the summer. The sky is blue, the air is fresh, and birds sing in the garden. People who live in Sydney seem to have an easy life style. They will tell you, "Don't worry. "
Many people think that Sydney is one of the most attractive cities in the world. It has many tall and modern buildings. Among them, Center point Tower is the tallest. Standing on the 305-metre(80 storeys)tower, you will have a great view of the city.
Sydney is famous for its deep harbor . The harbor has many bays and beautiful surf beaches. Among them, Bondi beach is the most popular. Sydney Harbor is not only beautiful, it also serves as a large port. Ships carry wool, wheat and meat from Sydney to other countries.
People living in Sydney like to call themselves Sydneysiders. They are mostly friendly and easygoing. When they are not working, they love to have a good time at the beach, swimming and sailing. [/INST] question: Sydney is the _ city in Australia. | options: A: youngest B: largest C: coldest D: hottest | answer: B </s> |
<s>[INST] context: Calendar of Events
WHAT'S GOING ON IN YOUR NEIGUHBORHOOD & LOCAL AREAS
Spring Wildflowers Around Unicol
The wildflower program will begin with a slide show and lecture on Wildflowers. There will be organized wildflower walks that will help both the novice and experienced wildflower enthusiast to better appreciate the color1ful and fascinating world of mountain wildflowers. Preregistration is required. 706 - 878 - 3983 $2 parking. prefix = st1 /1788 GA Hwy.356,Helen,GA, 706-878-3983, Toll Free: 800-573-9659, www.gas - tateparks.com. Directions:GA Hwy.356
Wings of Flight
Programs on birds, bats, butterflies included activities, educational discussions, crafts and more. Program fees may be required for some activities. $2 ParkPass.Please call 1-800-573-9656 for additional info.418 Amicalola Falls Lodge Road,Dawsonville,GA, 706-265-8888, Toll Free: 800 -573-9656. www.gastateparks.org. Directions:GA Hwy.52 from Dawsonville
3 rd ANNUAL EASTER EGG HUNT
The Chestatee Wildife Preserve, located in Dahlonega,Georgiapresents their 3 rd ANNUAL EASTER EGG HUNT. Fun and prizes for children ages 1 - 12. Admission is adults $ 10.00, children $ 5.00. April 12 th at 2:00 p.m.
The preserve houses a variety of over 100 different species of animals. Among the residents are Bengal and Siberian tigers, African and Barbary lions, chimpanzees, wallabies, kangaroos, wolves, fox, buffalo, white tigers, elk, peacocks and _ .
Chestatee Wildlife is open 7 days a week from 10 a.m. - 4 p.m. Call us at 706-864-9411.
Directions: 400 North to end. Continue on Longbranch Rd., 5 miles to Hwy. 52. turn right and follow 1 mile. Turn right onOld Dahlonega Hwy.We are 1/2 mile on the left. [/INST] question: All of the following are included in the wildflower program EXCPET_. | options: A: a slide show B: a discussion C: mountain flowers D: organized tours | answer: B </s> |
<s>[INST] context: A man had two large pots. One of the pots had a crack in it, so while the other pot always delivered a full pot of water at the end of the long walk from the stream to his house, the cracked pot arrived only half full. This went on every day for years.
One day a neighbor asked the man, "One of your pots has been broken for years. It can only deliver half its load, so you don't get full value from your efforts. Why don't you buy a new one?"
The man smiled and said, "Please follow me to my house, and you may see some beautiful flowers." On the way to the man's house, the neighbor took notice of the sun warming the beautiful wild flowers on the side of the path.
The man said to the neighbor, "Did you notice that there were flowers only on one side of the path, but not on the other side? That's because I have always known about the flaw of my pot. I planted flower seeds on one side of the path. Every day when I walk back from the stream, the broken pot waters them. For years, I have been able to pick these beautiful flowers to decorate my house. Without the broken pot, I would not have this beauty." [/INST] question: How much water did the man carry home every day? | options: A: A full pot B: Two full pots C: Half a pot D: One and a half pots | answer: D </s> |
<s>[INST] context: All the listed diseases except Q fever are tick-borne. The rickettsia C. burnetii causes Q fever, and humans are usually infected by aerosol of a sporelike form shed in milk, urine, feces, or placenta of infected sheep, cattle, or goats. Lyme disease is caused by a spirochete, Borrelia burgdorferi, and produces the characteristic lesion erythema chronicum migrans (ECM). The etiologic agent of Rocky Mountain spotted fever is R. rickettsia. It usually produces a rash that begins in the extremities and then involves the trunk. Two human forms of ehrlichiosis can occur: human monocytic ehrlichiosis (HME), caused by E. chaffeensis; and human granulocytic ehrlichiosis (HGE), caused by an as yet unnamed Ehrlichia. HME infection is transmitted by the brown dog tick and A. americanum. HGE infection is transmitted by I. scapularis, the same tick that transmits Lyme disease. Both infections cause fever and leukopenia. A rash rarely occurs. E. chaffeensis infects monocytes, and HGE infects granulocytes; both organisms produce inclusion bodies called morulae. Francisella tularensis is a small, Gram-negative, nonmotile coccobacillus. Humans most commonly acquire the organism after contact with tissues or body fluid of an infected mammal or the bite of an infected tick. [/INST] question: A 33-year-old man presents at OPD complaining of fever and headache. On examination, he had leukopenia and increased liver enzymes, and inclusion bodies were seen in his monocytes. History revealed that he went on camping and remembered removing a tick from his leg. Which of the following diseases is most likely causing the symptoms described? | options: A: Lyme disease B: Ehrlichiosis C: Rocky Mountain spotted fever D: Q fever | answer: B </s> |
<s>[INST] context: Patient [Ref- Reddy's Forensic 29/e p30; Parikh 6/e p1.441 "Generally speaking, it is for the patient in an action for negligence to establish the guilt of the doctor, whose innocence is otherwise assumed."- Parikh However, in cases where the rule of res ipso loguitur is applied, the patient need not prove negligence. Res ipso loquitur means that "the thing or fact speaks for itself." The patient has to merely state what according to him was the act of negligence. The 3 essential conditions considered necessary for res ipsa loquitur are: The nature of injury suggests by common knowledge or expe evidence that without negligence it does not occur. The patient must not contribute to his own injury The doctor had exclusive control over the injury producing instrument or treatment. Professional negligence Professional negligence is defined as absence of reasonable care and skill, or wilful negligence of a medical practioner in the treatment of a patient, which causes bodily injury or death of the patient. The word negligence is defined as the omission to do something (act of omission) which a reasonable person would do, or doing something (act of commission) which a reasonable person would not do. To prove an act of negligence the onus lies on the patient (or his relative if the patient has died). Following conditions must be proved by the patient (4Ds): Duty- the doctor (defendant) owed him a duty of care. Dereliction- the doctor failed to perfonn that duty. Damage- the patient suffered actual damage due to negligence of the doctor. iv. Direct causation- the doctor's negligence directly led to the damage without any other intervening cause. Professional negligence can be of 2 types: Civil negligence and Criminal negligence. Civil negligence Civil negligence arises - when a patient (or his relative, in case of patient's death) files suit in a civil cou to get compensation from his doctor for the injury or death of the patient due to doctor's negligence. - a doctor files civil suit to get fees from his patient, who refuses to pay alleging negligence. Criminal negligence Criminal negligence arises when the degree of negligence is so grave that it goes beyond matters of comensation. Case is filed in a criminal cou. Criminal negligence occurs when the doctor shows gross lack of competence, or gross inaction, gross recklessness, gross negligence in selection and application of remedies. It involves extreme depaure from the ordinary standard of care. Criminal negligence cases are very rare. Note that- A doctor will not be criminally liable if a patient dies due to an error of judgement or carelessness or want of due caution, though lie can be liable to pay compensation. Examples of criminal negligence? - Amputation of wrong limb or digit or of the wrong patient. - Leaving instruments, tubes, sponges or swabs within the body. - Gross mismanagement under the influence of alcohol or drugs - Performing criminal aboion - Administration of a wrong substance into the eye causing loss of vision. - Giving wrong or infected blood. - Gangrene after too tight plastering. Note that? Even if a doctor is negligent, a patient is not entitled for any compensation if no damage has occurred. An error in diagnosis or treatment is not negligence provided proper care and skill has been exercised. Contributory negligence is not a defence in criminal negligence. (Contributory negligence is any negligence on the pa of the patient or his attendant, which along with the doctor's negligence, contributed to the injury) Criminal negligence cases are dealt under I.P.C. section 304A. [/INST] question: In civil negligence, onus of proof lies on | options: A: Judicial first degree magistrate B: Police not below the level of sub inspector C: Doctor D: Patient | answer: D </s> |
<s>[INST] context: Cerebral malaria
Many adjuvant therapies have been suggested based on the prevailing pathophysiology and hypothesis of the time.
These include heparin, low molecular weight dextran, urea, high dose corticosteroid, aspirn, prostacycline, pentoxifflline, desferioxamine, anti TNF antibody, cyclosporin and hyperimmune serum.
Unfortunately, none have proved beneficial and several have proved harmful none of these adjuvants should be used, the cornerstone of management is good intensive care and correct antimalarial treatment.
Management of cerebral malaria
Antimalarial treatment
In cerebral malaria rapidly acting parenteral drugs should be given. Quinine is the drug of choice.
Fluid balance
Following admission patient should be rehydrated to a CVP of approximately 5 cm
Hypoglycemia
Slow intravenous injection of 50% dextrose water
Lactic acidosis
Hypovolemia should be corrected first
Acute renal failure
Fluid should be restricted to replace insensible losses only. Dialysis should be started early when there is evidence of multiple organ dysfunction.
Acute pulmonary edema
They should be nursed upright and given oxygen and the right-sided filling pressure should be reduced
Bleeding
Less than 5% of patients of cerebral malaria develop D.I.C. These patients should be given a fresh blood transfusion and vitamin K.
Bacterial superinfection / continued fever
Patient with secondary pneumonia should be given empirical treatment with a third-generation cephalosporin. [/INST] question: In complication of falciparum malaria, which drug is not given - | options: A: Phenobarbitone B: Dexmethosone C: Quinine D: Blood transfusion | answer: B </s> |
<s>[INST] context: The shock of the recent earthquake in Pakistan has brought another shock: the rise of a small, mysterious island, coming out from the water.
In the aftershock of the earthquake, people living in Gawadar, near the southwest coast, began to see a strange sight. They looked out into the Arabian Sea and saw a mountain-like shape coming out of the water. "I could see this gray, dome-shaped body in the distance, like a giant whale," Bahram Baloch, a local journalist, told the BBC. "Hundreds of people had gathered to watch it in disbelief ."
So what happened? The earthquake measured 7.7 in magnitude . The force was so strong that it moved the sea floor, releasing gas. This gas pushed the seabed, mostly rock and sand, upward and out of the water. This is how mud volcanoes are formed. The island that measures about 20 meters high, 30 meters long and 90 meters wide is actually the tip of the mud volcano.
Is it safe? Although people have visited this new island, scientists have found dangerous gas coming from the newly formed island. "Our team found bubbles rising from the surface of the island, which caught fire when a match was lit," said Mohammad Danish, a scientist, to Universe Today.
These mud volcanoes are not rare. But it's striking because this one has popped up in a populated area, and not far out in the sea. However, it's not expected to last very long. Most of these mud volcanoes are swept back under the sea within one year. [/INST] question: After the earthquake, what did people see in the sea? | options: A: a strange light B: a blue whale C: a mysterious island D: a mountain | answer: C </s> |
<s>[INST] context: The koala is one of Australia's most treasured creatures, which is a lovely little creature. But now, it is in big trouble.
Affected by habitat loss and climate change, like many other uniquely Australian animals, koalas are being squeezed into smaller regions. But at present, it is a deadly disease, a somewhat silent killer that causes a further decline in the koala population, that is worrying many scientists about the fate of the koala.
The killer is Chlamydia, which has caused symptoms in up to 50 percent of the wild koalas, with probably even more infected but not showing symptoms. It has been particularly severe in Queensland, where nearly all koalas are infected. The disease causes many symptoms including eye infections, which can lead to blindness, making it difficult for them to find their primary food.
Treating Chlamydia in wild koalas is a challenge. There is no treatment available for _ . Only a small percentage of the animals can be treated successfully and returned to the wild. Besides, there is no national plan in Australia to save the koala;it is up to each region to make management plans for its koala population.
The good news is that researchers are working to test a vaccine that would help prevent further spread. If all goes well, plans can be carried out to distribute the vaccil1e more widely. But it's impossible to vaccinate all wild koalas.
Another possibility would be to make vaccine distribution a routi11e part of treatment for the thousands of koalas brought into care centers every year after they are injured by cars or dogs.
While it is a combination of problems that are affecting the wild koala population, many experts believe this vaccine would be an important step in helping koalas survive longer. It may buy enough time to give researchers a chance to solve some of the other problems facing Australia's koalas. [/INST] question: Which isn't considered the main cause of koala's population decline? | options: A: Habitat loss B: Injuries from cars and dogs C: Climate change D: A deadly disease | answer: B </s> |
<s>[INST] context: The average person learns most of the 30 000~40 000 words whose meanings he or she recognizes by hearing them or getting familiar with them in the context or simply absorbing them without conscious effort. The best way to build a good vocabulary, therefore, is to read a great deal and to participate in a lot of good talks. There are relatively few words that we learn permanently by purposefully referring to dictionaries or keeping word lists. However, even those extra few are of value, and no one will make a mistake by working on developing a larger vocabulary. Here are some suggestions of how to do it.
Read plenty of good books. When you come across a new word, or a new meaning of an old word, stop and see if you can understand it from its context. If you can't, and if you can manage without interrupting the thought of the book too much, look it up in a dictionary or ask somebody and then repeat its meaning to yourself a couple of times. If you are really conscientious , write the word and its meaning in a personal vocabulary list - preferably using it in a sentence, or you can keep a special vocabulary notebook. Go over the list from time to time. Further, try to use a new word in writing or conversation a few times over the next several days.
Listen to good talks and be alert to new words you hear or to new meanings of words you already know. Then treat them just as you treat the new words you read.
Learn and be alert to the parts of words: prefixes, suffixes and roots. Knowing _ enables you to make intelligent guesses about the meanings of words.
If you are studying a foreign language, be alert to words in that language which relate to words in English. English has inherited or borrowed much of its vocabulary of 500 000~600 000 words from Latin, Greek, French, Spanish and German. [/INST] question: When you meet a new word in reading, what should you do? | options: A: Guess its meaning B: Ask somebody C: Look it up in a dictionary D: All of the above | answer: D </s> |
<s>[INST] context: Dick was a twenty-year-old man. His father was a teacher and taught chemistry in a middle school and his mother worked in a shop. They lived a happy life until his parents died one night when suddenly an earthquake broke out. Luckily his sister took him to see their aunt in the city and they did not stay at home. Everything was destroyed in the earthquake and the two children got into trouble. Thanks to their aunt who was not rich enough, they grew up but they lived a hard life. His sister was so sad that she became a nun . After he finished middle school, he was introduced to an owner of a hotel and began to work there.
One day the young man fell to the ground while he was cleaning a window on the second floor. He was sent to the hospital and the doctor looked him over. One of his legs was broken and he had to be in hospital. He said to the nurse, "I'm a poor man, madam. Arrange a third-class ward for me, please."
"Can't anybody help you?"
"No, madam," answered Dick. "I have only a sister. She's a nun and she's poor, too."
"I don't think so," the nurse said angrily. "Nuns usually marry God. And God is the richest in the world, you know!"
"Well, then," Dick said with a smile. "Please arrange a first-class ward for me and post the bill to my brother-in-law." [/INST] question: Dick's parents died _ . | options: A: in an accident B: in the war C: from the disease D: in the earthquake | answer: D </s> |
<s>[INST] context: The effect of the Great Lakes on weather in the region is called the lake effect. In winter*the lakes often have no ice in the middle. The seasonal winds from the west pick up the slightly warmer wet air from the lake surface. As the slightly warmer wet air passes over the colder land surface, it often produces heavy snowfall. This is similar to the effect of warmer air passing over mountain ranges, which often leads to dropping snow. During the period of freezing weather, the "snow belt",caused by the seasonal winds, receives regular snow fall and this phenomenon along the eastern shore forms the localized weather pattern, especially in Michigan, Ohio and so on.
The lakes also _ seasonal temperatures to some degree, by absorbing heat to cool the air in summer and then slowly giving out that heat in autumn. This function of the lakes protects the autumn against frost, and it also keeps the summer time temperatures cooler than further inland. This temperature buffering produces areas known as "fruit belts",where fruits typically grown farther south can be produced. That is why some southern fruits like apples ,cherries and grapes can be found in western Michigan near the lake shore as far north as the Grand Traverse Bay. The eastern shore of Lake Michigan and the southern shore of Lake Erie have many wine makers as a result of this.
However ,the lake effect has been found to be related to the occurrence of bad weather. For example, fogs are often formed over medium-sized areas along the shorelines of the lakes. This is most noticeable along Lake Superior's shores ,due to its coastal climate. A case in point is Hurricane Hazel in 1954,and tornadoes in Michigan and Ontario in 2007. Such evidence shows that the lake effect may help strengthen storms. [/INST] question: What result does "the lake effect" bring to the eastern shore? _ . | options: A: Seasonal winds B: Warmer wet air C: Mild weather D: Heavy snowfalls | answer: D </s> |
<s>[INST] context: VULVAL CARCINOMA: STAGING AND MANAGEMENT STAGE 1 1A Limited to vulva/perineumSize<=2cm stromal invasion <=1mm Wide local excision 1B Size >2cm stromal invasion >1mm Radical local excision plusB/L LAD: central lesionU/L LAD: lateral lesion (>2cm from midline) STAGE 2 Any sizeSpreads to lower 1/3 urethra, lower 1/3 vagina, anus Early: radical excision/ radical vulvectomy plus B/L LADAdvanced: radiation + surgery + LAD STAGE 3 Positive inguinofemoral lymph nodes Radiation + surgery + LAD STAGE 4 A 4B Upper urethra, upper vagina, bladder, rectum, pelvis side wallDistant metastasis, Pelvic or other lymph nodes Radiation + surgery + LAD LAD= lymphadenectomy This is stage iB (tumour size >2 cm with stromal invasion >1mm and no nodal involvement The lesion is lateral, not involving midline structures like clitoris or urethra Treatment of this stage is radical local excision with a tumor free margin of 1 cm with ipsilateral lymph node dissection. Bilateral lymph node dissection is done when midline structures are involved. [/INST] question: A 28 year old woman diagnosed with vulvar carcinoma. The lesion is on right labia, away from midline and measures 3 cm with stromal invasion of 2mm with no inguinal lymph nodes. Treatment is? | options: A: Wide local excision B: Radical local excision with 1 cm tumor free margin with ipsilateral lymph node dissection C: Radical local excision with 1 cm tumor free margin with bilateral lymph node dissection D: Radical local excision without LN dissection | answer: B </s> |
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