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<s>[INST] context: It's not just women who wear skirts. Men can wear them, too. In Scotland, men wear a kind of skirt called a kilt. The kilt is their national dress and an important part of their tradition .
A kilt is a colored skirt reaching down to the knees . It has checks on it with different colors, like red or blue. Each family in Scotland has its own colors.
How did the Scots start to wear kilts? There are many stories about it. One story is that the kilt was invented in the 1720s by an English factory owner, Thomas Rawlinson. Rawlinson had a lot of Scottish workers in his factory and he thought their clothing _ their work. So he cut their long clothes into a shorter skirt.
Today, most Scotsmen see kilts as formal dresses. They usually only wear them at weddings or big dinners. There are only a few men who still wear a kilt every day. Scots also wear kilts in parades when they play their traditional musical instrument : bagpipes . The army still has kilts as the dress uniform , but they no longer wear them to fight . [/INST] question: In Scotland, different families have different _ . | options: A: colors B: checks C: rules D: shapes | answer: A </s> |
<s>[INST] context: With a floor area larger than Beijing' Tian'anmen Square, the Guangdong Science Centre is known as the world's largest science and technology museum. The centre is located on Xiaoguwei Island and seen from a distance, it looks like a kapok flower of Guangzhou. It is one of the most famous "landmarks of Guangzhou".
It cost the government about 1.9 billion yuan to build the centre over five years. On September 27, 2008, it was opened to the public. The centre shows China's newest fruits of science and technology. It is full of exciting small machines and amazing small invention, waiting to help you understand interesting aspects of the world of science.
The centre offers eight exhibition areas, four science cinemas, two open labs and a digital "family experience" hall. Outside the main building, there is an 80,000-square-metre man-made lake for water-theme exhibitions and outdoor science square.
Exhibition: Children's World, Experience and Discovery, Transportation World, Digital World, Green Home, Flight Dream, The Human Body and health, Perception and Thinking
Opening hours: 9:30 am to 4:30 pm from Tuesday to Sunday; Closed on Monday (except public holidays and Golden Weeks)
Ordinary ticket: 60 yuan/person [/INST] question: When did the government begin to build the Guangdong Science Centre? | options: A: In 2001 B: In 2003 C: In 2005 D: In 2006 | answer: B </s> |
<s>[INST] context: The Himalayas are mountains that are located in South Asia. They are a part of Nepal, India, Pakistan, China and Bhutan. The mountains are the highest in the world, reaching almost 9,000 meters sea level. The Himalayas separate the Indian subcontinent from the inner part of Asia. The word Himalaya means " home of snow".
14 mountains are over 8,000 meters high, among them the K2, Nanga Parbat and Mount Everest, at 8,848 meters, the world's highest mountain. The Himalayas extend over 1,500 miles( 2,400km ) from the Indus valley in the west to the Brahmaputra Valley in the east.
Many of the mountain peaks are sacred to the people who live in the surrounding areas . Hindu and Buddhist pilgrims go there and pray to God.
The Himalayas belong to the youngest mountain ranges in the world. They were formed when the Indian subcontinent, which was originally a part of the southern landmass, drifted to the north and crashed into Asia. This movement started about 70 million years ago and has been going on up to the present day. The Himalayas are still becoming taller, moving at about 7 cm per year. Earthquakes and volcanoes are evidences that the area is still very active.
Glaciers and permanent snow fields cover the higher regions of the Himalayas. They are the source of streams that flow into the two big rivers of the region. The Indus flows to the west and through Pakistan into the Arabia Sea. The Ganges and Brahmaputra flow to the east and get together in Bangladesh. They form the largest delta in the world. [/INST] question: How many countries do the Himalayas belong to? | options: A: 7 B: 6 C: 4 D: 5 | answer: D </s> |
<s>[INST] context: Americans get really annoyed when people drive badly, smoke in no-smoking zones, or don't pick up after their dogs, but the rude behavior that annoyed them most is workplace discrimination, according to a survey.
The survey found workplace discrimination featured highly on the "Terrible Ten" list of rude behaviors.
In the survey,615 people from two companies in Baltimore and the University of Baltimore were asked to rank 30 examples of rude behavior ranging from text messaging when talking to someone, taking other people's food from the office fridge, to snubbing people.
Dr Forni, who conducted the survey, said he was surprised discrimination topped the list above other more usual bad habits in the workplace such as colleagues brushing their teeth in the water fountain.
"When a worker felt they weren't chosen for a project because they did not speak English as well as others, or felt they weren't promoted because of their national origin, age or sexual preference, they were really upset," he said.
"The American workplace is the most diverse in the world and the American worker is very sensitive to any kind of treatment that seems to be unfair."
Aggressive--behavior typical of rush hours--came second in the list with taking credit for someone else's work rounding out the top three, followed by treating service providers as inferiors.
Forni said it seemed from this survey that people were starting to focus more on the big issues. He said people were far more forgiving when family or friends behaved in a way seen as rude than work colleagues. "With the long hours that are so common today in the workplace, the real determinant of our ability to have a good or bad day is linked to the people we work with," he said. [/INST] question: Which of the following is NOT the reason why a man was refused for a job? | options: A: He speaks poor English B: He is too old C: He has been married D: He is from a poor country | answer: C </s> |
<s>[INST] context: The U.S. government may issue stronger regulations about the use of tobacco.
Many governments and private buildings have "No Smoking" regulations. In airplanes, on trains and at cinemas, Golf courses are seriously thinking of keeping out smokers, so are schools, shopping malls and even football fields.
So where do people go to fill their lungs with nicotine? The government is working on it.
One suggestion is that the government set aside a piece of land somewhere in the United States where smokers could go when they want a cigarette. Yellow Stone Park has been in the list, but many people don't agree because they fear that second-hand smoking would make the bears there sick.
The Mojave Desert in California is also being studied, and so are Las Vegas Casinos .
The smokers were not too nervous about the government idea.
They say they are not going to California just to light up. They have a right to smoke at home. To make life more pleasure for those who find it hard to give up smoking, the government is seriously thinking of getting somewhere for the smokers.
The tobacco companies are fighting the idea like mad. They say nobody has proved that cigarettes are bad for you. They say as a matter of fact, the doctors have proved that a cigarette saved a person's life after that person was shot.
Other places under consideration are: the cold areas in Alaska, the Rocky Mountain in Colorado and the Whitewater River in Arkansas. [/INST] question: Smokers in the U.S. _ to light a cigarette now. | options: A: find nowhere B: are not so free C: have no rights D: have to travel a long way | answer: B </s> |
<s>[INST] context: CDC Stage 3 (AIDS)-Defining Oppounistic Illnesses in HIV Infection:Bacterial infections, multiple or recurrentCandidiasis of bronchi, trachea, or lungsCandidiasis of esophagusCervical cancer, invasiveCoccidioidomycosis, disseminated or extrapulmonaryCryptococcosis, extrapulmonaryCryptosporidiosis, chronic intestinal (>1 month's duration)Cytomegalovirus disease (other than liver, spleen, or nodes), onset at age >1 monthCytomegalovirus retinitis (with loss of vision)Encephalopathy attributed to HIVHerpes simplex: chronic ulcers (>1 month's duration) or bronchitis, pneumonitis, or esophagitis (onset at age >1 month)Histoplasmosis, disseminated or extrapulmonaryIsosporiasis, chronic intestinal (>1 month's duration)Kaposi's sarcomaLymphoma, Burkitt's (or equivalent term)Lymphoma, immunoblastic (or equivalent term)Lymphoma, primary, of brainMycobacterium avium complex or Mycobacterium kansasii, disseminated or extrapulmonaryMycobacterium tuberculosis of any site, pulmonary, disseminated, or extrapulmonaryMycobacterium, other species or unidentified species, disseminated or extrapulmonaryPneumocystis jirovecii (previously known as Pneumocystis carinii) pneumoniaProgressive multifocal leukoencephalopathySalmonella septicemia, recurrentToxoplasmosis of brain, onset at age >1 monthWasting syndrome attributed to HIV(ref: Harrison's 19/e p1506,1215) [/INST] question: CDC Stage 3 (AIDS) - Defining Oppounistic Illnesses in HIV Infection doesn't include | options: A: Oral candidiasis B: Pneumocystis carini pneumonia C: Wasting syndrome D: Kaposi's sarcoma | answer: A </s> |
<s>[INST] context: Refer robbins 8/e p407 Lead poisoning occurs when lead builds up in the body, often over months or years. Even small amounts of lead can cause serious health problems. Children younger than 6 years are especially vulnerable to lead poisoning, which can severely affect mental and physical development. At very high levels, lead poisoning can be fatal. Symptoms Initially, lead poisoning can be hard to detect -- even people who seem healthy can have high blood levels of lead. Signs and symptoms usually don't appear until dangerous amounts have accumulated. Lead poisoning symptoms in children Signs and symptoms of lead poisoning in children include: Developmental delay Learning difficulties Irritability Loss of appetite Weight loss Sluggishness and fatigue Abdominal pain Vomiting Constipation Hearing loss Seizures Eating things, such as paint chips, that aren't food (pica) Lead poisoning symptoms in newborns Babies exposed to lead before bih might: Be born prematurely Have lower bih weight Have slowed growth Lead poisoning symptoms in adults Although children are primarily at risk, lead poisoning is also dangerous for adults. Signs and symptoms in adults might include: High blood pressure Joint and muscle pain Difficulties with memory or concentration Headache Abdominal pain Mood disorders Reduced sperm count and abnormal sperm Miscarriage, stillbih or premature bih in pregnant women [/INST] question: Punctate basophila are found in | options: A: DDT poisoning B: Mercury vapour inhalation C: Cyanide poisoning D: Lead poisoning | answer: D </s> |
<s>[INST] context: Necrotizing enterocolitis (NEC) is the most common life-threatening emergency of the GIT in the newborn period.
Management of necrotizing enterocolitis
Medical treatment of NEC include
Cessation of feeding
Nasogastric decompression
Administration of i.v. fluids
Systemic antibiotic against both gram +ve as well as gram -ye bacteria (after taking samples for blood culture).
Ventilation should be assisted if distention is contributing to hypoxia.
Early surgery consultation
Surgical interventions in NEC
Evidence of perforation is an indication for laparotomy and resection of necrotic bowel.
Failure to respond to medical management, a single fixed bowel loop, erythema of the abdominal wall and a palpable mass are additional indications of exploratory laparotomy, resection of necrotic bowel and external ostomy diversion.
Peritoneal drainage may be helpful for patients with peritonitis who are too unstable to withstand surgery. It is more successful in patients with isolated intestinal perforation. In many patients, no further surgical procedure is required.
Peritoneal drainage is performed under local anaesthesia. Alpenrose drain is placed in the right lower quadrant and permitted to drain peritoneal contents and decompress the abdomen. This procedure is employed predominantly in infants less than 1000g who have severe SIRS and are viewed as too unstable to be transported or to undergo laparotomy. In experienced hands, one-third of the patients require only drain placement.
A primary anastomosis at the time of initial surgery is indicated in patients with limited localized disease who have no distal bowel involvement and in patients who have demonstrated a walled-off perforation who are no longer manifesting the SIRS.
From this discussion, we choose the answer to be peritoneal drainage because:
Patients are on a ventilator (too unstable).
Surgery for NEC is resection and creation of an ileostomy, which is not given in the options.
Primary anastomosis is done only in stable patients with walled-off perforation. [/INST] question: A newborn suffering from perforated necrotizing enterocolitis is having the very poor general condition. He is currently stabilized on a ventilator. Which of the following should be done in the management of this patient – | options: A: Conservative treatment B: Resection and anastomosis C: Stabilization with membrane oxygenator and defer surgery D: Peritoneal drainage by putting drains in the flanks | answer: D </s> |
<s>[INST] context: Analyzing all the options one by one;
Option ‘a’…direct quote.. ‘about 5% to 10% of patients eventually develop acute myeloid leukemia or a myelodysplastic syndrome, possibly because hematopoietic stem cell have suffered some type of genetic damage’. (Robbins 8th/653) Even PNH is associated with aplastic anemia as both the disorders have an autoimmune basis.
Option ‘b’…direct quote.., aplastic anemia results from a fundamental stem cell defect supported by the presence of karyotypic aberrations in many cases; the occasional transformation of aplasias into myeloid neoplasms, typically myelodysplasia or acute myeloid leukemia; and the association with abnormally short telomeres. (Robbins 8th/664)
Option ‘d’…direct quote.. The term “myelodysplastic syndrome” (MDS) refers to a group of clonal stem cell disorders characterized by maturation defects that are associated with ineffective hematopoiesis and a high risk of transformation to AML. (Robbins 8th/625).
So the answer of exclusion is PCH (paroxysmal cold hemoglobinuria). It is an autoimmune haemolytic anemia due to IgG autoantibodies which bind to P blood group antigen and cause intravascular hemolysis and hemoglobinuria. Most cases are seen in children and have recovery within a month.....Wintrobes. [/INST] question: Which of the following is the least likely to be a preleukaemic condition? | options: A: Paroxysmal nocturnal haemoglobinuria B: Aplastic anaemia C: Paroxysmal cold haemoglobinuria D: Myelodysplastic syndrome | answer: C </s> |
<s>[INST] context: The World Bank has looked at the distinguishing features of successful school system.
According to the World Bank's education specialist, Harry Patrinos, this include: improving the quality of teachers and making sure that teachers are highly regarded; providing information to make schools accountable and giving autonomy to schools and head teachers.
This matters not only for individual pupils but also for the well-being of countries, he says, because improving educational performance has a direct impact on improving economic performance.
China's education performance-- at least in cities such as Shanghai and Hong Kong-- seems to be as spectacular as the country's fast growing economy.
Certainly both these open and outward-looking cities consider education to be important and are willing to adopt the best educational practices from around the world to ensure success. In Hong Kong, education accounts for more than one-fifth of entire government spending every year.
"Shanghai and Hong Kong are small education systems, with a concentration of ideas, manpower and resources for education," says Prof Cheng.
Under the banner "First class city, first class education", Shanghai set about systematically re-equipping classroom, upgrading schools and improving the curriculum in the last decade.
It got rid of the "key schools" system which concentrated resources only on top students and top schools. Instead staff were trained in more interactive teaching methods and computers were brought in.
About 80% of Shanghai school leavers go to university compared to an overall average of 24% in China.
Meanwhile, dynamic Hong Kong was forced into educational improvements as its industries moved to cheaper mainland Chinese areas in the 1990s.Its survival as a service and management hub depends on upgrading knowledge and skills.
In the last decade Hong Kong has concentrated on closing the gap for all students, says a report by McKinsey management consultants.
The report, How the World's Most Improved School Systems Keep Getting Better, rated Hong Kong's education system among the best in the world. [/INST] question: The World Bank's survey about education mainly concentrates on _ . | options: A: what has made some education systems successful B: China's education system and competitive exams C: how to relieve Chinese students of their heavy schoolwork D: the relationship between education and economic development | answer: A </s> |
<s>[INST] context: The first outstanding deaf teacher in America was a Frenchman Laurent Clerc. He and Thomas Hopkins Gallaudet founded America's first school for the deaf.
When Laurent Clerc was one year old, he fell into a fire. As a result, he lost both his hearing and his sense of smell. At the age of 12, Laurent entered the Royal Institution for the Deaf in Paris. After he graduated, the school asked him to stay on as an assistant teacher.
Meanwhile, in America, Thomas Hopkins Gallaudet was studying to be a minister when he met a young deaf girl, Alice Cogswell. He was upset to learn that there were no schools for the deaf in America. Therefore, in 1815, Gallaudet sailed to London to seek ideas on how to teach deaf people. However, he was unable to get help. He met a French educator of the deaf who invited him to Paris to learn at the Royal Institution for the Deaf.
Gallaudet went to the Royal Institution for the Deaf, where Clerc became his Sign Language teacher. The two worked and studied well together. When the time came for Gallaudet to return to America, he asked Clerc to come with him.
The two men set sail on June 18, 1816. The voyage across the Atlantic Ocean took 52 days; however, Clerc and Gallaudet put the time to good use. They discussed the school for the deaf which they planned to open. On the long trip, they had many conversations about education and deafness. The year after they arrived, they founded a school for the deaf in Harford, Connecticut. [/INST] question: America's first school for the deaf was founded _ . | options: A: in 1816 B: in 1817 C: by a Fenchman D: by an American | answer: B </s> |
<s>[INST] context: The following story took place long ago in Israel. One day when government officials were rebuilding an office, they found a mouse hole in a corner and used smoke to force the mice inside the hole to come out. A while later they indeed saw mice running out, one after another.
Then, everyone thought that all the mice had escaped. But just as they were just about to start to clean up, they saw two mice squeezing out at the exit of the hole. After some endeavor, the mice finally got out. The strange thing was that after they came out of the hole, they did not run away immediately. Instead, one chased after the other near the exit of the hole. It seemed that one was trying to bite the tail of the other.
Everyone was puzzled, so they stepped closer to take a look. They realized that one of the mice was blind and could not see anything, and the other one was trying to allow the blind mouse to bite on his tail so he could pull the blind one with him to escape.
After witnessing what happened, everyone was speechless and lost in thought. During meal time, the group of people sat down in a circle and started to chat about what happened to the two mice.
One serious Rome official said: "I think the relationship between those two mice was that of emperor and minister." The others thought for a while and said: "That was why!" Thus the Rome official showed his arrogance .
A smart Israeli said: "I think the relationship between those two mice was husband and wife." Again the others thought for a while, and all felt it made sense; so they expressed agreement. Therefore, the Israeli's countenance (,)showed self-satisfaction.
A Chinese, who was accustomed to the firm tradition of loyalty to parents, said: "I think the relationship between those two mice was that of mother and son." Once again the others thought for a while, and felt this was more reasonable. So they expressed agreement yet another time. Therefore, the face of the Chinese showed professional modesty.
At that moment, one pure-minded Samaritan who was squatted on the ground resting his chin in his hands, bewilderedly looked at other people, and asked: "Why did those two mice have to have a certain relationship?"
Suddenly, the atmosphere froze. Then the group looked back at the Samaritan and remained speechless. The Rome official, the Israeli and the Chinese who had spoken earlier all lowered their heads in shame, and did not dare to respond.
In fact, the true love is not established on benefit, friendship and loyalty or blood relationship. Instead, it is based on no relationship. [/INST] question: Why didn't the two mice escape immediately? | options: A: They didn't know about the danger B: One was trying to bite the tail of the other C: They couldn't find the right direction to run away D: One was trying to help the other to escape together | answer: D </s> |
<s>[INST] context: Before the elevator was invented in the late 1800s,buildings were much smaller and lower,as people did not want to walk up and down stairs all day.With the invention of the elevator came high-rise buildings and _ .
Some people find elevators make them a little uncomfortable because there are many people all standing close in a small room.It is best just to relax and enjoy the ride.
When the elevator doors open,stand aside and let everyone out before you try to get in.Even if you are in a hurry,it's impolite to push someone so that you can get into an elevator.
Don't stare at people or stand too close.Try to keep your eyes looking ahead or you could make others feel nervous or uncomfortable.
If you have to move past people to get out of the elevator,say"Excuse me,please"or"I'm sorry"rather than just push them out of the way.Others will think you're welcome if you show some politeness.
If you are standing close to the buttons ,ask others what floors they are going to and press the buttons for them.This is considered to be polite.
In case of emergency ,follow the instructions written inside the elevator and try to keep others calm. [/INST] question: The elevator was invented _ . | options: A: in 1800 B: in 1899 C: in the 18th century D: in the 19th century | answer: D </s> |
<s>[INST] context: Password strength has been a topic about the Internet lately. I have seen lots of clever methods for generating and remembering strong passwords. Some are better than others, but in my opinion , none are adequate . Here's the problem : it doesn't matter how strong your passwords are if you use the same one on multiple sites. All it takes is for a site to get hacked , like Gawker media, or even Sony did , and now your super-strong password has been stolen , and every site on which you used that password has been accessed .
So, the bottom line is that no matter how strong your passwords are , and no matter what clever tricks you use to help you remember them , if you surf the Internet often , the only truly secure password system is what you need .
Enter LastPass. It's not the only password manager out there, but I like it the best. You create ONE strong password that you have to memorize and use it to access your LastPass database . The LastPass database is stored online, on LastPass's servers. LastPass recognizes the site you're on and automatically logs you in (after , optionally , asking you to re-enter your master password). LastPass also has automatic form fill and automatic password generation. This means that you can have a different , unique , very strong password for every site you log into , but you only have to remember one master password . It's the best of both worlds.
One argument against LastPass is that if their database is attacked , then all of your sites are in danger, and that's true, but given that their entire line of work is keeping that information safe , I'm willing to take that chance. The alternative is rolling dice or picking phrase to create passwords, writing all of them down on a piece of paper or something , and then having to manually type them in when I go to a site . A terrible mess.
There is a free version of LastPass , with additional features unlocked if you pay $ 12 for a year's subscription .
----Joshua Bardwell [/INST] question: When using LastPass , users have to remember _ . | options: A: all passwords used B: the last password C: unique password each time D: the master password only | answer: D </s> |
<s>[INST] context: (a) To see patellofemoral articulationExplanationStandard portals in knee arthroscopy1. Anterolateral portal- Almost all the structures within the knee joint can be seen except the posterior cruciate ligament, the anterior portion of the lateral meniscus, and the periphery of the posterior horn of the medial meniscus in tight knees.- Located 1cm above the joint line, 1cm lateral to the margin of the patellar tendon.2. Anteromedial portal- Used for additional viewing of lateral compartment and insertion of probe for palpation of medial and lateral compartment structures.- Placed 1cm above the medial joint line, 1cm inferior to the tip of patella, and 1cm medial to the edge of the patella.3. Posteromedial portal- Located on the soft triangular soft spot formed by the posteromedial edge of the femoral condyle and the posteromedial edge of tibia.- Used for viewing the posteromedial structures and for repair or removal of the displaced posterior horn of meniscal tears and for posteromedial loose body removal.4. Superolateral portal.- Used for diagnostically viewing the dynamics of patella-femoral joint, excision of medial plica.- Located just lateral to the quadriceps tendon and about 2.5cm superior to the superolateral corner of patella. [/INST] question: Anterolateral arthroscopy of knee is for: | options: A: To see patellofemoral articulation B: To see the posterior cruciate ligament C: To see the anterior portion of lateral meniscus D: To see the periphery of the posterior horn of medial meniscus | answer: A </s> |
<s>[INST] context: Source of energy for muscular activityThe immediate source of energy for all muscle contraction is ATP, followed immediately by creatine phosphate.In sternous exercise ATP store is sufficient only for 1-2 seconds and creatine phosphate for another 5-7 seconds. Thus, energy rich phosphagen stores (ATP and creatine phosphate) permit severe muscle contraction for 8-10 seconds only.After this, energy is obtained from the metabolism of stored glycogen or from circulating glucose and free fatty acids, depending upon the availability of oxygen.Energy source during in exercise can be summarized by : -i) Sho burst of intense activity (e.g., 100 meter sprint or weight lifting) : - All energy comes from ATP and creatine phosphate. Breakdown of these compound is an anaerobic processes.ii) Little longer intense exercise (e.g., 200 meter sprint or 100 meter swim) :- Besides ATP and creatine phosphate, glycogen is metabolised by anerobic glycolytic pathways to provide a ready source of energy. So, muscle work is anaerobic.iii) Longer duration exercise (e.g., jogging, marathan run) : - The muscle work is aerobic and energy comes from aerobic utilization of glucose and free fatty acids. More glucose is utilized at the initial stage, but as the exercise is prolonged, free fatty acids become the predominant fuel. [/INST] question: Main source of energy in 1 min is ? | options: A: Glycogen B: FFA C: Phosphates D: Glucose | answer: A </s> |
<s>[INST] context: When you discuss about eating out with your friend, first of all, you must make it clear who will pay for the meal.If somebody suggests having lunch with his friend, he might simply say something like this "I'm afraid it'll have to be some place nearby ,as I have little money." The other person may say. "OK. I'll meet you at Mcdonald's." This means he has agreed that the two will go Dutch, that is, each person pays for himself. He may say "Oh, no. I want to take you for lunch at Johnson's " This means the person is to pay the bill for both of them. Although the other person is pleased with the invitation, there is one reason why he shouldn't accept it by simply saying "Thank you."
American customs are much the same as those in other parts of the world. American women used to expect men to pay for all the meals. But today, some of them like to. However, if a woman is asked to attend a dinner or a dance outside, the invitaton itself means "Come as my guest". So, as you see, it is a polite thing to make the situation clear at the very beginning. [/INST] question: _ is first of all when you discuss about eating out with your friend. | options: A: What to eat B: Where to eat C: Who will pay for the meal D: When to eat | answer: C </s> |
<s>[INST] context: This one is about the differential diagnosis of panniculitis.
Panniculitis refers to a broad spectrum of disease that involves inflammation of the fatty layer of the skin
The tissue layer under the skin (epidermis and dermis) is called the subcutaneous fat or panniculus.
Inflammation of this layer of fatty tissue is called panniculitis
Due to panniculitis, the overlying skin appears as a red or purplish lump.
Both erythema nodosum and weber Christian disease are characterized by panniculitis.
Their clinical presentation is quite similar and there is not much to separate the two diseases.
Both the diseases present with tender erythematous nodules on the lower legs.
Systemic features such as fever, malaise, weight loss and arthralgia are seen in both the disease.
Facts which favour the diagnosis of erythema nodosum in the question
The lesions in Weber Christian disease are bilateral and symmetrical
The clinical course of Weber Christian disease is characterized by exacerbations and remissions
The involved areas manifest as recurrent crops of erythematous tender nodules.
It is a rare disease and is usually seen in elderly females (30-60 yrs).
The patient in the question gives a history of fever & malaise for 2 weeks which is a classic feature of erythema nodosum (erythema nodosum is associated with preceding streptococcal infection). [/INST] question: 25 years old male having fever & malaise for 2 weeks, arthritis of ankle joint and tender erythema-tons nodules over the shin. Diagnosis is – | options: A: Erythema nodosum B: Hensen's disease C: Weber–christian disease D: Urticarial vasculitis | answer: A </s> |
<s>[INST] context: A number of investigations may be abnormal in patients with renovascular disease. Renal function may be impaired and plasma renin activity may be elevated, sometimes with hypokalaemia due to hyperaldosteronism. Ultrasound may reveal a discrepancy in size between the two kidneys. Unfounately, these simple non-invasive tests are insufficiently sensitive for screening in hypeensive patients and vascular imaging is required to diagnose renovascular disease. Such imaging is usually undeaken only in patients in whom intervention to improve renal perfusion would be contemplated; this is usually limited to young patients and those in whom blood pressure cannot be controlled with antihypeensive agents ('resistant hypeension'), those who have a history of 'flash' pulmonary oedema or accelerated phase ('malignant') hypeension, or those in whom renal function is deteriorating. CT and MRI angiographic techniques have largely replaced Doppler ultrasound or renal isotope scanning (including 'captopril renography') in diagnosing renal aery stenosis. Conventional renal aery cannulation and aeriography is now usually undeaken for therapeutic rather than diagnostic purposes. CT angiography entails large intravenously administered doses of contrast medium which may be nephrotoxic. ref:Harrison's principles of internal medicine,ed 18,pg no 2045 [/INST] question: Ideal imaging modality for Renal aeria hypeension- | options: A: IVP B: USG C: Angiography D: Renin assay | answer: C </s> |
<s>[INST] context: Monty Robert's father was a horse trainer. As a child, Monty often went from one farm to another with his father. Sometimes they didn't have money to pay for food, but Monty still kept hoping to own a horse farm.
When he was in school, his teacher asked him to write a paper about his dream. He wrote a seven-page paper. He wanted to have a horse farm one day. He even drew a picture of a horse farm in the paper.
The next day he handed it in to his teacher. Two days later, he got his paper back. On the front page was a large red "F" with the words "See me after class". So the boy did and asked his teacher, "Why did I get an F?" The teacher said, "This dream will not come true for a young boy like you. You need a lot of money to own a horse farm. You have to buy the land. You have to pay for a lot of things. There is no way you could ever do it." Then the teacher added, "If you write this paper again with a simpler dream, I will give you a good grade."
After school he thought hard about it. At last, he decided to hand in the same paper, making no changes at all. He said to the teacher, "You can keep the F and I'll keep my dream."
Many years later, Monty had his own large horse farm. His dream came true.
So don't let anyone take away your dreams. Follow your dreams, no matter what they are. [/INST] question: What was Monty's attitude towards his paper? | options: A: Careless B: Serious C: Joking D: Funny | answer: B </s> |
<s>[INST] context: The positive leukocyte esterase test indicates the presence of neutrophils in the urine, suggesting a bacterial infection. The nitrite test exploits the fact that most Enterobacteria (gram-negative enteric rods) are able to form nitrite from nitrate; thus, the nitrite test is used to diagnose urinary tract infections. One limitation of this method is the fact that enterococci (gut streptococci) do not produce nitrite from nitrate, but can nonetheless cause urinary tract infections. Enterococcal urinary tract infections are often nosocomial and classically acquired in the intensive care unit, although they can occur in other settings. Enterobacter sp., Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa can cause urinary tract infections and would usually be picked up by the dipstick for nitrites. False-negative results might still be seen with these organisms if the infection was light, the bladder had been recently emptied prior to collection, and the urine was "new" and had not yet grown enough bacteria to produce a positive result. [/INST] question: A 35-year-old woman presents to her gynecologist with complaints of burning on urination for the past 2 days. Dipstick test of her urine demonstrates marked positivity for leukocyte esterase, but not reactivity for nitrite. Urine culture later grows out large numbers of organisms. Which of the following bacteria are most likely to be responsible for this patient's infection? | options: A: Enterobacter sp B: Enterococcus faecalis C: Escherichia coli D: Klebsiella pneumoniae | answer: B </s> |
<s>[INST] context: It must be something that many American companies hold a baby contest.Of course, babies are wonderful, and many parents would be the first to agree.Companies really bring in much money.
Walgreens Baby contest
If you play the new Baby Milestones Challenge Contest by BabyCenter & Walgreens, you could win $1,000 in Walgreens & Beauty.com Gift Cards and Certificates.You can play the instant winner if you get a $25 Walgreen's gift card, but you also have to write down your email address and receive all their sales and other information for the contest.
Kids and Babies
Kids and Babies are accepting entries for May 2014 Free Photo Contest.Baby Photo Galley with theme albums and age group albums is moved to the new website Cute Baby Gallery.Check KidsandBibs.com for their Baby Photo Contest blog's latest update.The grand prize is $25,000.The catch: Winners are decided by the visitors coming to the site and voting for their favorite babies, so you have to advertise their site for them.
Parents.com
Parents.com has a website only for their members, but if you are into baby photos, it is well worth surfing.You could receive offers on free samples, money-saving coupons , and chances to win the latest contests.
Avon
Avon is another company that has a baby photo contest this spring.Avon is advertising their newest collection.It is Avon's only collection for the photos of babies.Babies' age: newborn to 2 years.Just go to TinyTillia.com and upload your recent baby's photos.The first place baby will be featured in a Tiny Tillia Storybooks and win a $5,000 U.S.Savings Bond.Ten beautiful girls will win $300 worth of Tiny Tillia products.
The tip is to run a search engine for all the latest contests going on and start entering them today.You could be lucky and win enough to put your baby through college! Have fun! [/INST] question: What is the basic condition for you to play the instant winner in Walgreens & Beauty.com? | options: A: Getting a gift card B: Getting a certificate C: Winning 1,000 dollars D: Receiving information for the contest | answer: A </s> |
<s>[INST] context: Antioxidants may counteract the effects of reactive oxygen species (ROS) that may accumulate acutely and chronically within cells as a consequence of environmental insults and pathologic processes. Certainly, health food stores promote this concept with sales of products such as vitamin E. However, cellular damage is multifactorial, and proving that one compound has a significant effect is difficult. Analgesics ameliorate the perception of pain from cellular damage, but they do not prevent or diminish cell damage; they only mask it. Antimicrobials may help the body's own immune defenses against infectious agents and shorten and/or diminish tissue damage. However, long-term use of antimicrobials is discouraged because it may alter the body's own useful microbial flora, and it can promote development of drug-resistant strains that pose a serious health risk for the general population. (As Mr. Spock noted, "The needs of the many outweigh the needs of the few.") Antineoplastic agents are given for malignancies and rarely have benefit for cancer prevention. Glucocorticoids provide short-term improvement in well-being, but when used for longer periods, they have deleterious effects. [/INST] question: A study of aging shows that senescent cells have accumulated damage from toxic byproducts of metabolism. There is increased intracellular lipofuscin deposition. Prolonged ingestion of which of the following substances is most likely to counteract this aging mechanism? | options: A: Antioxidants B: Analgesics C: Antimicrobials D: Antineoplastic agents | answer: A </s> |
<s>[INST] context: A few years ago, in one experiment in behavioural psychology, Stanley Milgram of Yale University tested 40 subjects for their willingness to obey instructions given by a "leader" in a situation in which the subjects might feel a personal dislike of the actions they were called upon to perform. Specifically, Milgram told each volunteer "teacher-subject" that the experiment was in the noble cause of education, and was designed to test whether or not punishing pupils for their mistakes would have a positive effect on the pupils' ability to learn.
The teacher-subjects were placed before a panel of thirty switches with labels ranging from "15 volts of electricity (slight shock)" to "450 volts (danger -- severe shock)" in steps of 15 volts each. The teacher-subject was told that whenever the pupil gave the wrong answer to a question, a shock was to be administered. The supposed "pupil" was in reality an actor hired by Milgram to pretend to receive the shocks by giving out cries and screams. Milgram told the teacher-subject to ignore the reactions of the pupil, and to administer whatever level of shock was called for.
As the experiment unfolded, the "pupil" would deliberately give the wrong answers to questions, thereby bringing on various electrical punishments, even up to the danger level of 300 volts and beyond. Many of the teacher-subjects _ administering the higher levels of punishment, and turned to Milgram. In these situations, Milgram calmly explained that the teacher-subject was to carry on with the experiment and that it was important for the sake of the experiment that the procedure be followed through to the end. What Milgram was trying to discover was the number of teacher-subjects who would be willing to administer the highest levels of shock, even in the face of strong personal and moral revulsion against the rules and conditions of the experiment.
Before carrying out the experiment, Milgram explained his idea to a group of 39 psychiatrists and asked them to predict the average percentage of people who would be willing to administer the highest shock level of 450 volts. The overwhelming consensus was that basically all the teacher-subjects would refuse to obey the experimenter. The psychiatrists felt that "most subjects would not go beyond 150 volts" and only a small percentage of about one in 1,000 would give the highest shock of 450 volts.
What were the actual results? Well, over 60 per cent of the teacher-subjects continued to obey Milgram up to the 450-volt limit! In repetitions of the experiment in other countries, the percentage was even higher, reaching 85 per cent in one country. How can we possibly account for this result?
One might firstly argue that there must be some sort of built-in animal aggression instinct that was activated by the experiment. A modem sociobiologist might even go so far as to claim that this aggressive instinct was of survival value to our ancestors in their struggle against the hardships of life on the plains and in the caves, finally finding its way into our genetic make-up.
Another explanation is to see the teacher-subjects' actions as a result of the social context in which the experiment was carried out. As Milgram himself pointed out, "Most subjects in the experiment see their behaviour in a larger context that is good and useful to society -- the pursuit of scientific troth. The psychological laboratory has a strong claim to legitimacy and gains trust and confidence in those who perform there. An action such as shocking a victim, which in isolation appears evil, acquires a completely different meaning when placed in this setting".
Here we have two different explanations. The problem for us is to sort out which of these two polar explanations is more reasonable. This is the problem of modern sociobiology -- to discover how hard-wired genetic programming decides the interaction of animals and humans with their environment, that is, their behaviour. Put another way, sociobiology is concerned with explaining the biological basis of all behaviour. [/INST] question: Why did Milgram do the experiment? | options: A: To discover people's willingness for orders from leaders B: To display the power of punishment on ability to learn C: To test people's willingness to sacrifice for science D: To explore the biological basis of social behavior | answer: D </s> |
<s>[INST] context: A paperclip,made of steel wire bent into a looped shape,is an instrument used to hold sheets of paper together.This common device is a wonder of simplicity and function.But where did this simple,cheap,and practical invention come from?
In the late 19th century,the most common way to hold papers together was by using a pin.Although the pin was an inexpensive tool and was easily removable,it would 1eave holes in the paper. Later,as steel wire became more common,inventors began to notice its elastic feature. With this feature,it could be stretched and twisted into various clip--like objects.In the years just before 1900,quite a few paperclip designs appeared.The name most frequently associated with the paperclip invention is Johan Vaaler,a Norwegian inventor. However, Vaaler's clips were not the same as the paperclips currently in use.Specifically,they did not have the inside loop we see today.The familiar looped design was invented by Gem Manufacturing Ltd.in England.This clip is therefore sometimes known as the Gem clip.
Because of Vaaler,the paperclip played an important historical role in Norway.During World War II,Norway was occupied by the Nazis.Norwegians were prohibited from wearing any symbol of their national unity ,such as buttons with the initials of their king.Thus,in protest,they started wearing paperclips to show their unity.The reason for doing this was simple:Paperclips were a Norwegian invention whose original function was to bind together.After the war,a giant paperclip statue was put up in Oslo to honour Vaaler--even though his design was never actually produced. [/INST] question: One way the paperclip is better than the pin is that _ | options: A: it is cheaper B: it is simpler C: it can be removed more easily D: it doesn't damage the paper | answer: D </s> |
<s>[INST] context: The Man Booker Prize for Fiction is awarded for a novel written by a writer from the Commonwealth or the Republic of Ireland and it aims to represent the very best in contemporary fiction. The prize was originally called the Booker-McConnell Prize, which was the name of the company that sponsored it, though it was better-known as simply the 'Booker Prize'. In 2002, the Man Group became the sponsor and they chose the new name, keeping 'Booker'.
Publishers can submit books for consideration for the prize, but the judges can also ask for books to be submitted that they think should be included. Firstly, the Advisory Committee gives advice if there have been any changes to the rules for the prize and selects the people who will judge the books. The judging panel changes every year and usually a person is only a judge once.
Great efforts are made to ensure that the judging panel is balanced in terms of gender and professions within the industry, so that a writer, a critic, an editor and an academic are chosen along with a well-known person from wider society. However, when the panel of judges has been decided, they are left to make their own decisions. Meanwhile, the prize sponsor has no further right to take part in any more.
The Man Booker judges include critics, writers and academics to maintain the consistent quality of the prize and its influence is such that the winner will almost certainly see the sales increase considerably, in addition to thePS50,000 that comes with the prize. [/INST] question: Who can submit books to the prize? | options: A: Judges B: Writers C: Readers D: Sponsors | answer: A </s> |
<s>[INST] context: The first chocolate was eaten by people in South America hundreds of years ago. In those days, the people did not really eat chocolate. They used the cocoa bean to make a chocolate drink and they enjoyed it very much. Many years later, the cocoa bean was brought to other countries and people came to love the taste of chocolate.
In 1824, John Cadbury opened a small shop in Britain. One of the things he sold was chocolate drink. In 1831, he opened a factory to make chocolate drink. He wanted to encourage people to drink chocolate instead of other drinks. A few years later, a man called Joseph Fry found a way to make chocolate instead of only drinking it. But at that time chocolate was very expensive and only the rich people could buy it. Later, ad more and more chocolate bars were produced and sold, it became cheaper.
However, at first only plain chocolate (a kind of chocolate without milk and with very little sugar) was produced. Milk chocolate came later and this was made by adding milk to the chocolate. The first milk chocolate bar was made in Cadbury's factory in 1897. Their most famous chocolate, Cadbury's Milk Bar, was made in 1905, It has been the most popular chocolate in Britain and around the world for over 100 years. The Cadbury factory is still in Britain and the chocolate produced there is eaten all over the world. Every year, thousands of visitors visit the factory in order to see how chocolate is made. [/INST] question: Hundreds of years ago, people first began to drink chocolate in_. | options: A: South Americ B: South Africa C: Britain D: Australia | answer: A </s> |
<s>[INST] context: A 15-year-old American has become the youngest person to climb the highest mountains on each of the seven continents, completing the feat by summiting Antarctica's Mount Vinson over the weekend.
Jordan Romero, who last year at age 13 became the youngest person to climb the world's tallest peak Mt Everest, was descending to base camp on Sunday after reaching the summit of Vinson Massif with a team that included his father and stepmother, according to his team's website. "We're at the roof of Antarctica," a member of Team Jordan said in a webcast from near the 4897-metre peak on a frigid but "legendary day".
Romero beat the record previously held by Britain's George Atkinson, who in May completed the seven ascents at the age of 16. The junior mountaineer from Big Bear Lake, California has been hooked on climbing from an early age. When he was just 10, he became the youngest person to climb Mt Kilimanjaro, Africa's highest peak at 5895 meters.
Before his 11th birthday, he had another world record under his belt, summiting Europe's Mt Elbrus, in Russia's Caucasus mountains, in July 2007. Five months later, it was the 6962-metre Mt Aconcagua in Argentina, followed by Alaska's Mt McKinley at 6194 meters. In September 2009 at age 13, he climbed Indonesia's Carstensz Pyramid, at 6194 meters the tallest island peak in the world, breaking another record. Eight months later in May 2010, he climbed Everest, and ever since he and his team had been preparing for his Antarctic expedition.
"Looking forward to tomorrow, and we'll make you guys proud and promise we'll come back home safe and sound," Romero said in a webcast on Saturday, hours before he began the final ascent to Mt Vinson's summit.
The team had intended to reach the top on Christmas Day, but ideal weather and good progress allowed them to summit a day ahead of schedule. [/INST] question: Which mountain stands in Asia? | options: A: Mt. Vinson B: Mt. Everest C: Mt. Kilimajaro D: Mt. Elbrus | answer: B </s> |
<s>[INST] context: My grandfather is eighty years old now.He always complains about how fast things have changed, and he often says that life used to be better.
Families aren't families they used to be.A lot of families have broken up.If husband and wife have problems with their _ , they no longer stay together.And mothers used to stay at home and take care of their children, but now not any more.Everyone is busy working.Mother used to spend all day cooking in the kitchen.But now the family don't eat home-cooked food any more.
And the cars! No one walks any more.More and more people drive.Students used to walk 5 miles to school every day, even in winter.But now students don't.And in school, children don't have to think any more.In math class, for example, they used to add, subtract, multiply and divide in their heads.Instead, they use calculators .
And people today have TV and computers, and they don't talk to each other any more.They are too busy to talk, too busy to eat, too busy to think....
Life used to be simple, but it isn't any more. [/INST] question: What changes have happened to some families? | options: A: a, b, d B: b, c, d C: a, c , d D: Lots of couples live apart because of unhappy problems | answer: C </s> |
<s>[INST] context: French writer Le Clezio won the 2008 Nobel Prize in Literature, the Swedish Academy announced Thursday.
The Academy _ Le Clezio as "author of new departures and poetic adventure, explorer of humanity beyond civilization."
Le Clezio, 48, received much attention with his first novel The Interrogationin 1963 and made the breakthrough as a novelist withDesertin 1980, for which he was rewarded a prize from the French Academy.
This novel Desertcontains magnificent images of a lost culture in the North African desert, contrast with a description of Europe seen through the eyes of unwanted immigrants, the Swedish Academy said in the statement.
The emphasis in Le Clezio's work has increasingly moved in the direction of an exploration of the world of childhood and of his own family history, the academy added.
Le Clezio was born 1940 in Nice of France, but both parents had strong family connections with the former French colony Mauritius.At the age of eight, he moved to Nigeria with his family. During the month-long voyage to Nigeria, he began his literary career with two books Un long voyageandOradi noir.
He has taught at universities in Bangkok, Mexico City, Boston, Austin and Albuquerque among other places. Since the 1990s, Le Clezio and his wife share their time between Albuquerque in New Mexico, the island of Mauritius and Nice.
This was the fourth of the prestigious Nobel Prizes handed out this year, with awards in chemistry, physics and medicine made in the past three days.
The Nobel Prizes have been awarded annually since 1901 to those who "conferred the greatest benefit on mankind during the preceding year."
The annual Nobel Prizes are usually announced in October and are handed out on Dec. 10, the anniversary of the 1896 death of Alfred Nobel, a Swedish industrialist and the inventor of dynamite .
Each prize consists of a medal, a personal diploma and a cash award of 10 million Swedish kronor (1.4 million U.S. dollars). [/INST] question: Which of Le Clezio's works won him the 2008 Nobel Prize in Literature? | options: A: The Interrogation B: Desert C: Un Long voyage D: Oradi noir | answer: B </s> |
<s>[INST] context: BEIJING--Heavy haze still covered north and east China on Saturday, with
highways closed and flights delayed or canceled .
The smoggy weather affected the country's land from north to south, including Beijing, Hebei, Shandong, Jiangsu, Shanghai, Zhejiang, Hunan, Guangxi and Guangdong, with visibility less than 50 meters in some areas.
Cities like Shanghai and Nanjing have been enveloped in the grey sky for the past several days. Many walkers in the street had to wear masks. In the Lukou airport in Nanjing, Jiangsu Province, more than 60 inbound and outbound flights were canceled on Saturday because of the hazy, which also forced primary and middle schools and kindergartens to stop classes on Thursday and Friday in Nanjing.
The Ministry of Environmental Protection said earlier this week that there were several main reasons behind the widespread haze: unfavorable weather conditions making it difficult for pollutants to diffuse , motor vehicle exhaust , coal use for winter heating.
The Chinese government now plans to clean up the air by cutting coal use, closing some factories and promoting cleaner production.
"We must face up to the realities," said Yan Naiqiang, a professor of environmental science at Shanghai Jiao Tong University. "The treatment of smog will be a long battle." [/INST] question: Which city was not affected by the smoggy weather on Saturday? | options: A: Hunan B: Zhejiang C: Guangdong D: Hainan | answer: D </s> |
<s>[INST] context: "Iris scan , please," the bank's computer voice tells you . You step up and the computer reads your eye , comparing it to the stored file it has of your iris. The images had better match--otherwise you won't be able to get your money.
Iris scanning and other technologies , such as fingerprint and voice scanning , have appeared in many science fiction movies in the past. Today , these advanced technologies are part of the real world. They are common at work, the bank, the airport, and your local prison. The iris scan, fingerprint scan, and voice scan are all examples of biometrics a fast developing area of automatic personal identification technology . Basically , biometrics uses various ways to verify a persons identity , based on the individual's unique characteristics ,including fingerprints , voices, irises, body heat patterns, facial images, handprints , signatures and so on.
Biometrics identification systems have a number of advantages over password systems. The primary advantage is that an individual has to be physically present in order to be identified. Another important advantage is that there are no passwords to remember , forget, lose or steal.
The voice scan is the simplest and most affordable form of biometrics . It only requires a computer, a microphone and the correct software. The software records a subject's voice and then compares it to a stored voice sample for identification purposes.
For additional safety, fingerprint and handprint scans can also be employed . Fingerprint scans take the image of a fingerprint and compare it to a stored file of prints. Handprint scans identify the unique features of a hand.
Iris scans currently give the highest level of accuracy among all the available biometrics systems. Another technology , full facial scans , is currently in use at border crossings and airports. Facial scanning equipment can actually track and identify moving faces within a crowd.
The potential of biometrics is exciting and encouraging . With continued development , testing , and application , current technologies will become even more effective in the future. Soon , the days of password and car keys will be gone . Just don't leave home without your fingerprints! [/INST] question: Which is the most accurate form of biometrics? | options: A: The voice scan B: The fingerprint scan C: The iris scan D: The facial scan | answer: C </s> |
<s>[INST] context: During her sixty-year career performing, Lena Horne entertained people with her beauty and rich, emotional voice. She used her fame to fight social injustices toward African-Americans.
Lena Horne was born in New York in 1917. At sixteen, Lena became a dancer at the famous Club in New York City. After taking voice lessons, she soon became a singer. In 1940, Lena Horne became the first African-American to perform with an all-white jazz band. After performing at a club in Hollywood, California, she caught the attention of filmmakers. She soon began making movies. Her films became very popular. In the 1940's, Lena Horne was the first African-American in Hollywood to sign a long-term contract with a major movie studio. Her deal with MGM stated that she would never play the role of a servant. She refused to play roles that represented African-Americans disrespectfully . But this refusal also limited her movie career.
Lena Horne once said that World War Two helped make her a star. She was popular with both black and white soldiers. She sang on army radio programs and traveled to perform for the troops. Once, she noted that German prisoners of war were permitted to sit closer to the stage than black soldiers. She was very angry. These experiences led to Lena Horne's work in the civil rights movement.
Lena Horne sang at civil rights gatherings. She took part in the March on Washington protest in 1963. It was during this event that Martin Luther King Junior gave his "I Have a Dream" speech. She protested racial separation at the hotels where she performed. She took action so that she and her musicians would be allowed to stay in those hotels. Black musicians at the time generally stayed in black neighborhoods.
Lena Horne died in New York in 2010. [/INST] question: How old was Lena Horne when she died? | options: A: 86 years old B: 93 years old C: 98 years old D: 88 years old | answer: B </s> |
<s>[INST] context: Jane was running late. Jane, 25, had a lot to do at work, plus visitors on the way: her parents were coming in for Thanksgiving from her hometown. But as she hurried down the subway stairs, she started to feel uncomfortably warm. By the time she got to the platform, Jane felt weak and tired---maybe it hadn't been a good idea to give blood the night before, she thought. She rested herself against a post close to the tracks.
Several yards away, Tom, 43, and his girlfriend, Jennifer, found a spot close to where the front of the train would stop. They were deep in discussion about a house they were thinking of buying.
But when he heard the scream, followed by someone yelling, "Oh, my God, she fell in!" Tom didn't hesitate. He jumped down to the tracks and ran some 40 feet toward the body lying on the rails. "No! Not you!" his girlfriend screamed after him.
She was right to be alarmed. By the time Tom reached Jane, he could feel the tracks shaking and see the light coming. The train was about 20 seconds from the station.
It was hard to lift her. She was just out. But he managed to raise her the four feet to the platform so that bystanders could hold her by the grins and drag her away from the edge. That was where Jane briefly regained consciousness, felt herself being pulled along the ground, and saw someone else holding her purse.
Jane thought she'd been robbed. A woman held her hand and a man gave his shirt to help stop the blood pouring from her head. And she tried to talk but she couldn't, and that was when she realized how much pain she was in.
Police and fire officials soon arrived, and Tom told the story to an officer. Jennifer said her boyfriend was calm on their 40-minute train ride downtown-just as he had been seconds after the rescue, which made her think about her reaction at the time. "I saw the train coming and I was thinking he was going to die," she explained. [/INST] question: Why did Jennifer try to stop her boyfriend? | options: A: Because they would miss their train B: Because he didn't see the train coming C: Because she was sure Jane was hard to lift D: Because she was afraid the train would kill him | answer: D </s> |
<s>[INST] context: Disulfiram Pharmacological treatment of opioid dependence (Harrison 17' Ye p. 2732) Methadone maintenance: ? Methadone is a synthetic opioid chemically dissimilar but pharmacologically very similar to morphine. Methadone is used as substitution therapy in opioid dependence. The basic aim is to replace an opioid with another opioid that has the following propeies. - Lower abuse/addiction potential - Incapable of a giving a kick - Where tolerance develops slowly - Withdrawl syndrome develops gradually - Legally accessible - Can be taken orally and has a relatively long half life. These propeies of the drug help in blocking heroin induced euphoria while decreasing craving. - Methadone occupies the opioid receptor thus reducing the desire to take other opioids. - Addicts who are cooperative enough to take oral methadone experience reduced craving and less kick/buzz/rush from intravenous heroin because their opioid receptor are already occupied by methadone and the intravenous drug must compete with it. - This helps the patient to maintain abstinence for opioids. - Over three quaers off patients in well supervised clinics are likely to remain heroin free for 26 months. - After a period of maintenance (usually 6 months to -2. 1 year) the dose of methadone is gradually tapered off. Alternative medicines that have been used for maintenance treatment are:? Buprenorphine: - Buprenorphine is a paial agonist at the p receptor. Buprenorphine has several advantages over methadone. - Low overdose danger - Potentially easier detoxification than with methadone. - Probable ceiling effect in which higher doses do not increase euphoria. Opioid antagonists (Naltrexone) Naltrexone is a competitive opioid antagonist at it, cS, 7C It is long acting. It can be used orally to assist in the rehabilitation of ex opioid abusers who are fully withdrawn from opioids (otherwise it will induce an acute withdraw! syndrome). A patient who then takes an opioid fails to experience the "kick" or euphoria. Naltrexone does not reduce the craving. Use of clonidine in opioid withdrawl: -(Goodman Gilman 11th/e p. 619) Clonidine is an a2 adrenergic agonist that decreases adrenergic neurotransmission from locus ceruleus. Most of the autonomic symptoms of opioid withdrawl results from loss of opioid suppression of locus ceruleus. Clonidine acts distinct receptor but by cellular mechanisms that mimic opioid effects. So it can allete many of the symptoms of opioid withdrawl. Postural hypotension is common with opioid withdrawl, therefore, dose of clonidine, must be titrated according to the stage and severity of withdraw!. Ioxfexidine It is also an a2 adrenergic agonist. It has greater selectivity for a2Aadrenergic receptors and is associated with less hypotension. [/INST] question: Which is NOT used in treatment of heroindependence? | options: A: Disulfiram B: Buprenorphine C: Clonidine D: Lofexidine | answer: A </s> |
<s>[INST] context: The word "day" has two meanings. When we talk about the number of days in a year, we are using "day" to mean 24 hours. But when we talk about day and night, we are using "day" to mean the time between sunrise and sunset. Since the earth looks like a ball, the sun can shine on only half of it at a time. Always one half of the earth is having day and the other half night. A place is moved from day into night and from night into day over and over by the spinning of the earth. At the equator day and night are sometimes the same length. They are each twelve hours long. The sun rises at 6 in the morning and sets at 6 in the evening. For six months the North Pole is tilted toward the sun. In those months the Northern Hemisphere gets more hours of sunlight than the Southern Hemisphere. Days are longer than nights. South of the equator nights are longer than days. For the other six months the North Pole is tilted away from the sun. Then the Southern Hemisphere gets more sunlight. Days are longer than night. North of the equator nights are longer than days. Winter is the season of long nights. Summer is the season of long days. [/INST] question: When the Western Hemisphere is having day, the Eastern Hemisphere is having _ . | options: A: both day and night B: day C: neither day nor night D: night | answer: D </s> |
<s>[INST] context: Should you stay at home to look after your child,or return to work?
Maybe you don't have the option.Combining work and motherhood is an issue faced by increasing numbers of women every day.
New research for the Institute for Economic and Social Research could solve this quandary once and for all.In short,it concludes that going back to work after the birth of a child can have a negative impact on the child's development--unless you have lots of money.
"Growing up in a family in which the mother chooses to work appears to have some adverse consequences for children's welfare," the research says.However,it adds that extra money brought in by both parents can reduce the negative effect.The negative effect is also less apparent in children of bettereducated mothers.
The research by John Ermisch and Marco Francesconi is especially downbeat about welfare to work programmes,and especially,the prospects for the children of some single parents.
"It is hard to see anything but gloomy prospects for the children of single parents (who are generally poor)," the researchers said.This is because in a common family where both parents work,extra money brought in by the mother's working would compensate for less time spent with the children.
In contrast,the researchers said the effects of paternal employment were far more modest,but this did not mean that fathers had no role in shaping their children's welfare.Money brought in by the father would be a major resource for helping children develop.
The research says,however,that before parents get too carried away by worrying about working,there are more important issues facing a child's development.Parents' personalities and emotional stability,parenting practices,and the friends and networks that children experience while growing up will be much bigger factors than whether their mothers work. [/INST] question: The extra money brought in by both parents _ . | options: A: plays different roles in shaping a child's welfare B: can reduce the negative effect on a child C: has negative effect on a child's development D: may damage the life of children | answer: B </s> |
<s>[INST] context: How often do you use your car? Can you use your car less often? Do you know the following facts in the UK?
* About 50% of all car journeys are just for fun.
* Over 80% people go to work by car.
* 25% car journeys are under two miles.
* 70% car journeys are under five miles.
WALKING & CYCLING
Instead of using the car for short journeys, why not walk or ride a bicycle? Walking is a most popular form of exercise--it's healthy and it can save you money. If you work nearby, try walking or cycling instead of driving.
BUSES
Bus companies are using new buses: some run on new fuels which produce less pollution; some have easier access for disabled and old people. There are special traffic lanes to make bus journeys easier and more reliable. So do something to help solve the pollution problem--let the bus take you to work and your children to school.
TRAINS
All car journeys, long or short, can be hard work. For some trips it is wiser to take the train. Leave your car at home and walk, cycle or take a bus to and from the station. Train travel is fast, safe and comfortable. Train tickets are not always expensive; some are quite cheap at discount. [/INST] question: How many of car journeys are just for fun in the UK? | options: A: 25% B: About 50% C: 70% D: Over 80% | answer: B </s> |
<s>[INST] context: Jane Scott is fourteen and the year before last she began to study in a middle school. She likes dancing and singing and spends a lot of time on them. But she hates math and does not work hard at it. She thinks it difficult to learn. She falls behind her classmates and once failed the math exam. She decides to drop it. Her father is angry with her when he knows about it.
It was Sunday. Mr Scott gave a call to his sister, who teaches math in another school. He hoped she would come and tell his daughter how to learn math. The woman came quickly and said. "You're a clever girl, Jane. I'm sure you'll soon do well in math if you work hard at it."
"I'm afraid I can't, Aunt," said Jane, "Girls can't be good at math."
"I don't think so," said the woman. "I was good at it when was a girl. You must do more exercises and practice a math problem again and again until you master it. Remember: Practice makes perfect. Well, it's a math problem. Think about it and practice it again, and you'll work it out."
"OK," said the girl, "Let me try."
About an hour later, Jane took the exercise book to her aunt and said, "I've done the problem ten times."
"Well done!" her aunt said happily, "What result did you get?"
"Ten answers." [/INST] question: Jane has difficulty in learning _ . | options: A: dancing B: math C: singing D: English | answer: B </s> |
<s>[INST] context: The composition of breast milk varies at different stages after birth to suit the needs of the baby.
According to the postnatal period the breast milk is divided into -
1. Clostrum
Is the milk secreted during the first three days after delivery.
It is yellow and thick.
It contains more antibodies and cells and high amounts of vitamins A, D, E, K, & "Protein".
2. Transitional milk
Is secreted during the following two weeks (after clostrum).
The immunoglobulin and protein content decreases while the fat and sugar content increases.
3. Mature milk
Follows transitional milk.
It is thin and watery but contains all the nutrients essential for optimal growth of the body.
According to feed the breast milk is divided into -
1. Fore milk
It is watery and is rich in protein, sugar, vitamins, minerals and water that satisfy the baby's thirst.
2.Hind milk
Comes towards the end of feed
Rich in fat content and provides more energy, and satisfies the baby's hunger.
The milk of mother who delivers prematurely differs from the milk of a mother who delivers at term –
Preterm milk
Contains more protein S, sodium, iron, immunoglobins and calories as they are needed by the preterm baby. [/INST] question: Colostrum is rich in the following constituents as compared to breast milk – | options: A: Minerals B: Proteins C: Fats D: Carbohydrates | answer: B </s> |
<s>[INST] context: Physical examination reveals petechiae (pinpoint, nonraised, purplish red spots caused by intradermal hemorrhage) on the chest and stomach. Catalase-positive and coagulase negative The patient is probably suffering from bacterial endocarditis caused by S. epidermidis infection of the prosthetic hea valve. S. epidermidis Coagulase-negative organism Unable to ferment mannitol Sensitive to novobiocin Resistant to penicillin. Patients with congenital hea malformations, acquired valvular defects (for example, rheumatic hea disease), prosthetic valves, and previous bacterial endocarditis show an increased incidence of bacterial endocarditis. Intravenous drug users also have a high risk for infection. S. viridans can be ruled out, because streptococci are catalase negative, which is a feature that distinguishes them from catalase-positive staphylococci. S. aureus is coagulase positive so it is ruled out. S. saprophyticus is coagulase negative but resistant to novobiocin, hence also ruled out here [/INST] question: A 57-year-old man arrives at the emergency room complaining of weakness, fatigue, and intermittent fever that has recurred for several weeks. The patient had a cardiac valvular prosthesis implanted 5 years ago. Blood cultures grew ceain gram-positive cocci on which catalase and coagulase test were done. The gram-positive organisms failed to ferment mannitol, and their growth was inhibited by novobiocin. CATALASE TEST SLIDE COAGULASE TEST Lesions seen on skin What is the most likely infectious agent? | options: A: Staphylococcus aureus B: Staphylococcus epidermidis C: Staphylococcus saprophyticus D: Streptococcus viridans | answer: B </s> |
<s>[INST] context: Tony Wheeler was born to travel. His father worked for an airline. For the first 16 years of his life, Wheeler and his family lived in many different countries.
In the early 1970s,Tony met a young woman named Maureen. They
soon married. Before getting jobs, Tony and Maureen wanted to travel. They took a year long trip from England, through Asia, to Australia. On
the trip,they visited places like Iran ,India, and so on.
When Tony and Maureen arrived in Australia, people asked many
questions about their trip. To answer these questions, Wheeler wrote a book called Across Asia on the Cheap. The book told people about different countries' weather, customs , and places to see. But unlike other travel books then,Tony Wheeler's book also talked about places most
tourists did not go. He also wrote about unusual things to see and do. The book was very popular.
Tony and Maureen started a company called Lonely Planet. They
continued travelling. They wrote books for each place they visited. Today,800 people work {or Lonely Planet. The company has over 650 books. Tony Wheeler,the great traveller, still writes about travels to many places and will bring us more surprises. [/INST] question: Tony Wheeler and his wife ended the year-long trip in _ . | options: A: England B: Iran C: India D: Australia | answer: D </s> |
<s>[INST] context: Many students are under great pressure this term. There is some advice on studying and preparing for exams.
Sciences
Ask students what is the most difficult course, and most of them will give you the same answer: mathematics. This is also true for Dai Shuang, a 14-year-old student at No.1 Middle School. He says, "It's so difficult that I get a headache whenever I think about the math exam."
According to Dai, studying this course is not easy. He usually studies math by himself and spends most of his free time reading math books and doing exercises.
_
Qin Xia, a math teacher, offers some advice. "Most students fear mathematics because they think the class is too difficult or boring." he says, "These students don't listen carefully in classes or even sleep." In Qin's opinion, they can try to take notes. And they'd better ask teachers for help. It's difficult for students to teach themselves math, which will waste a lot of time. Besides, doing a lot of exercises is also important.
Arts
Zhu Tianjiao, a 13-year-old student at Megan Middle School, is very nervous because she doesn't know how to improve her English.
_
Xia Bingcong, a top student at Tsinghua University shares some of her learning experiences. According to Xia, memorizing, listening and reading are important in language learning. "Studying on a daily basis is the best choice." Xia says. [/INST] question: When the math exam comes, Dai Shuang usually _ . | options: A: has a bad cold B: sleeps late C: has a hard time D: feels excited | answer: C </s> |
<s>[INST] context: B cell Nearly 1 to 20% of people who receive a solid organ transplant develop a lymphoma. - Lymphomas have also been repoed (though less .frequently) after bone-marrow transplants .for other disorders. Why does it happen? - Post-transplant lymphomas are almost always related to infection by the Epstein Barr Virus (EBV). - Infection by the Epstein Barr Virus causes a transformation of B-cells which becomes cancerous. In normal individuals other cells of the immune system can tackle the EBV infection, but for organ transplants high doses of drugs that suppress the immune system must be administered. With nothing to control the infection, the chances of developing lymphomas increase. The two main factors that determine the chances of getting lymphoma are: How much immunosuppressive treatment is required - The more the immunosuppression, the more the chances of EBV infection. The status of EBV serology of the recipient of the transplant - If this individual has previously been infected by EBV the chances are that the body remembers the infection and the blood already has called antibodies that can identify and kill the virus. Clinical features Post-transplant lymphomas are usually different .from the usual Non-Hodgkin lymphomas. While most patients have involvement mainly of lymph nodes, other organs are very commonly affected as well. These include the brain, lungs and the intestines. The transplanted organ can also get involved. Treatment Whenever possible, immunosuppressive treatment has to be reduced or stopped. In those who have small and localized disease, surgery or radiation may be attempted. If not, the first line of treatment is usually Rituximab, a monoclonal antibody that specifically targets lymphoma cells. Only when this. fails is chemotherapy attempted. Chemotherapy is deferred until necessary as in paially immunosuppressed individuals, chemotherapy may fuher increase the risk of infections. In those who develop lymphomas after bone marrow transplants, donor leukocyte transfusions can be highly effective. Prognosis of Post transplant lymphomas In general, non-Hodgkin lymphomas occurring after organ transplants have a poorer outcome than other NHLs. Around 60-80% of the victims ultimately succumb to their lymphoma. Involvement of brain has poor prognosis [/INST] question: Post transplant lymphoma is ? | options: A: T cell B: B cell C: Null cell D: NK cell | answer: B </s> |
<s>[INST] context: Coincidences happen all the time to ordinary people, but the following events are perhaps some of the strangest of them all.
1. In the 19thcentury, the famous writer, Edgar Allan Poe, wrote a book called The Narrative of Arthur Gordon Pym of Nantucket. It was about four survivors of a shipwreck who were in an open boat for many days before three of them decided to kill and eat the cabin boy whose name was Richard Parker. Some years later, in 1884, the boat Mignonette sank, and only four survivors were left in an open boat for many days. Finally the three older members killed and ate the cabin boy. The name of the cabin boy was Richard Parker.
2. In Monza, Italy, King Umberto I went to a small restaurant for dinner. When the owner took King Umberto I's order, the King noticed that he and the restaurant owner were doubles, in face and in build. Both men began discussing the resemblance between each other and found many more similarities. Both men were born in the same place, on the same day, of the same year (March 14, 1844, Turin, Italy). On the day that the King married Queen Margherita, the restaurant owner had married a lady named Margherita. The restaurant owner opened his restaurant on the same day that King Umberto I was crowned King of Italy. On July 29, 1900, King Umberto I was informed that the restaurant owner had died that day in a shooting accident, and as he expressed his regret, someone in the crowd killed him!
3. Mark Twain was a popular American author who wrote famous books such as The Adventures of Tom Sawyer and Adventures of Huckleberry Finn. Mark Twain was born on the day of the appearance of Halley's Comet in 1835, and died on the day of its next appearance in 1910. He himself predicted this in 1909, when he said: "I came in with Halley's Comet in1835. It is coming again next year, and I expect to go out with it." [/INST] question: In The Narrative of Arthur Gordon Pym of Nantucket, _ . | options: A: the boat was named Mignonette B: the ship sank after the cabin boy's death C: three people in all eventually survived the shipwreck D: Richard Parker was unfriendly to the other survivors | answer: C </s> |
<s>[INST] context: Anyone who has ever lost keys or money will have wished for a simple but effective way to make sure it never happens again. A US company is trying to help.
Using a tiny microchip which is implanted into the arm, they have come up with a replacement for cash or credit cards that cannot be left at home or dropped on the bus.
The Verichip is about the size of a grain of rice and works using radio frequency identification technology. At a shop, a radio frequency "reader" would send a signal and the chip in your arm would respond with your unique identity number. That would give the "reader" your financial information, and money could be taken directly from your accounts and you wouldn't even have to reach for your wallet.
The company also hopes to include other information on the chip, such as medical records, building security codes and passwords, making life even easier.
But not everyone is happy with the developments. Critics say that a lot can go wrong with the chip. A clever thief could build a fake reader that would steal your information without you knowing. So your money could still be stolen. Privacy is a big issue too. Stores, or even the government, only need to track the chip to find out what you buy, how much you spend and where you go.
And if you wanted to get rid of your chip, you would need an operation to remove it. [/INST] question: The Verichip is _ . | options: A: the identity number B: the security code C: a tiny microchip D: a radio reader | answer: C </s> |
<s>[INST] context: On Tuesday,a new study published in the American Heart Association's journal Circulation:Heart Failure revealed that women who ate five or more dishes of baked fish a month had a thirty percent lower risk of heart failure in comparison to women who ate less than one dish a month.
Researchers examined the diets of 84,493 women,whose ages ranged from 50 to 79.The women who had eaten lots of baked fish like salmon ,were more healthy than those who mostly ate tuna or white fish. Eating baked fish also appeared to provide a protection against high blood pressure. The study also found that those women who ate more baked fish were likely to have a lower weight,exercise more and eat more fruits and vegetables in comparison to those who ate fried fish.
Researchers noted that past research had discovered the fatty acids in fish probably decreased the risk of high blood pressure by improving blood pressure along with heart and blood functioning. This study showed the link between eating fish and heart failure risk but it was not designed to show cause and effect.
This study also showed that just by eating one dish of fried fish a week led to a 49% greater risk of heart failure,and eating fried fish led to lower fiber intake and higher calorie intake.
The American Heart Association suggested eating a minimum of two dishes of fish especially fatty fish each week. [/INST] question: Compared to the women who ate fried fish those who ate more baked fish could _ . | options: A: be more relaxed B: be more healthy C: eat more every day D: raise blood pressure | answer: B </s> |
<s>[INST] context: New Zealand is beautiful no matter what time of the year or season you visit. The best time to visit New Zealand is the time that suits you best. The weather in New Zealand is fine all year round. However, if you have more than one date in mind, the following information may help with your travel plans.
The warmest months of the year are from September to April. December, January and February are the three hottest months of the year. It is summer. The long summer days are wonderful for water sports.
Spring is from September to November. It can be hot, warm or cool. The weather is quite different. That depends on the places you visit. You can travel to Alexandra in Central Otago and Hastings in Hawk's Bay.
Autumn is from March to May. It is a pleasant season in New Zealand. The temperature is a few degrees lower than that of summer.
The winter season runs from June to August. The mountainous areas are covered with snow during winter and there is a little rainfall in some places. This is a good time for skiing. [/INST] question: Which sport is suitable in December and January in New Zealand? | options: A: Going skating B: Playing soccer C: Going swimming D: Going skateboarding | answer: C </s> |
<s>[INST] context: More than 15 million Britons, many of them women, will holiday unaccompanied this year. And they will no longer be treated as second-class citizens. After 50 years of being slighted, ripped off, herded together and allocated the worst rooms in the hotel, the single traveller's time has finally come. Rather than being viewed as an awkward peculiarity in the standard couples-and-families "system", single travelers have become travel's fastest growing sector and a phenomenon that tour operators are falling over themselves to catch up with.
In one sense, the boom is the result of people postponing marriage and children. Approximately 39% of the adult British population--19 million people--is now single and the proportion of one-person households has increased from 18% in 1971 to 29% last year. The most significant growth of singles over the next few years is expected to be within the well-off, travel-hungry 25-34 age group.
The expansion in single travel is being increased by women. Women are just as happy as men to leave partner at home and head off on holiday. On adventure group trips single women constitute more than half of all travelers, and Internet agents report that 70% of their single clients are women.
Women today see being single as an opportunity to travel, rather than as an obstacle. The result is that travel companies are now attempting to work out new ways of attracting singles----a market worth PS10.4 billion. The number of specialist singles tour operators has risen from a couple to at least 10, but they face a growing challenge from mainstream operators, who now propose to target solo travelers with moves like abolishing single room supplements. At the moment, single travelers usually have to join a group, or pay more. As soon as we get beyond that, the singles market is going to take off to a completely new level. [/INST] question: Solo travellers are now _ | options: A: not being recognized B: mainly aged 25-34 C: experiencing better service D: not a profitable market | answer: C </s> |
<s>[INST] context: There are few bacteria for which antimicrobial susceptibility is highly predictable. However, some agents are the drug of choice because of their relative effectiveness. Among the three antibiotics that have been shown to treat legionellosis effectively (erythromycin, rifampin, and minocycline), erythromycin is clearly superior, even though in vitro studies show the organism to be susceptible to other antibiotics.Penicillin remains the drug of choice for S. pneumoniae and the group A streptococci, although a few isolates of penicillin-resistant pneumococci have been observed. Resistance among the pneumococci is either chromosomally mediated, in which case the minimal inhibitory concentrations (MICs) are relatively low, or plasmid-mediated, which results in highly resistant bacteria. The same is generally true for H. influenzae. Until the mid-1970s, virtually all isolates of H. influenzae were susceptible to ampicillin. There has been a rapidly increasing incidence of ampicillin-resistant isolates, almost 35 to 40% in some areas of the United States. Resistance is ordinarily mediated by b-lactamase, although ampicillin-resistant, b-lactamase-negative isolates have been seen. No resistance to penicillin has been seen in group A streptococci.C. difficile causes toxin-mediated pseudomembranous enterocolitis as well as antibiotic-associated diarrhea. Pseudomembranous enterocolitis is normally seen during or after administration of antibiotics. One of the few agents effective against C. difficile is vancomycin. Alternatively, bacitracin can be used.Lyme disease, caused by B. burgdorferi, has been treated with penicillin, erythromycin, and tetracycline. Treatment failures have been observed. Ceftriaxone has become the drug of choice, particularly in the advanced stages of Lyme disease. [/INST] question: The antibiotic of choice for streptococcal pharyngitis is | options: A: Penicillin B: Ampicillin C: Erythromycin D: Vancomycin | answer: A </s> |
<s>[INST] context: Paclitaxel It is a complex diterpin taxane obtained from bark of the Western yew tree, which exes cytotoxic action by a novel mechanism. It enhances polymerization of tubulin: a mechanism opposite to that of vinca alkaloids. The microtubules are stabilized and their depolymerization is prevented. This stability results in inhibition of normal dynamic reorganization of the microtubule network that is essential for vital interphase and mitotic functions. Abnormal arrays or &;bundles&; of microtubules are produced throughout the cell cycle. Cytotoxic action of paclitaxel emphasizes the impoance of tubulin-microtubule dynamic equilibrium. The approved indications of paclitaxel are metastatic ovarian and breast carcinoma after failure of first line chemotherapy and relapse cases. It has also shown efficacy in advanced cases of head and neck cancer, small cell lung cancer, esophageal adenocarcinoma and hormone refractory prostate cancer. The major toxicity is reversible myelosuppression and &;stocking and glove&; neuropathy. Chest pain, ahralgia, myalgia, mucositis and edema can be troublesome. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:825 [/INST] question: 'Stocking and glove' neuropathy is seen in: | options: A: Vinblastine B: Paclitaxel C: Etoposide D: Mitoxantrone | answer: B </s> |
<s>[INST] context: Malignancy is a recognized risk factor for venous thromboembolism (VTE), and VTE is the second leading cause of death in cancer patients. Procoagulant molecules expressed both by cancer cells and host tissue contribute to this condition. Low-molecular-weight heparin (LMWH) is the preferred anticoagulant for long-term treatment in patients with cancer. When compared with warfarin, LMWH reduces the rate of recurrent VTE without significant risk of bleeding. Newer anticoagulants such as rivaroxaban have not been adequately tested for cancer-induced VTE yet.Young patients with unprovoked VTE, a history of unexplained VTE, or family history of VTE raise the suspicion of an inherited hypercoagulable disorder. The common inherited hypercoagulable disorders are Factor V Leiden mutation, prothrombin gene mutation, protein S deficiency, protein C deficiency, antithrombin III deficiency, dysfibrinogenemia, and antiphospholipid antibody syndrome. When inherited hypercoagulable disorders are strongly suspected, tests for above mentioned disorders can be ordered. In the event of an acute thrombosis, however, it is not recommended to test for protein C, protein S, and anti-thrombin III since active coagulation can reduce the plasma concentration of these proteins resulting in false-positive result. To avoid confusion, it is recommended to order only Factor V Leiden mutation, prothrombin gene mutation, and antiphospholipid antibody with acute VTE or when patients are on warfarin.Warfarin-induced skin necrosis results from a transient hypercoagulable state. Warfarin initially affects all the vitamin K-dependent clotting proteins (Factors II, VII, IX, X, and proteins C and S). Since Protein C has a short half-life (8-12 hours), the serum protein C concentration drops quickly to 50% of normal in first 24 hours. Since circulating levels of other vitamin K-dependent proteins are still high, this gives rise to a hypercoagulable state which may cause microthrombi in the dermal and subcutaneous vessels, resulting in skin necrosis. The risk is particularly high in case of congenital protein C deficiency; nearly one-third cases of warfarin-induced skin necrosis are associated with congenital protein C deficiency. [/INST] question: A 62-year-old man is evaluated in the ER for sudden onset of swelling of the right calf with pain for past 2 days. The patient noticed the swelling after he woke up from sleep and had pain while walking. He cannot recollect any history of trauma, denies any recent travel, and has never had a blood clot in the past His medical history is remarkable for hypertension, adequately controlled with lisinopril, and stage-III squamous cell carcinoma of the lung for which he recently completed six cycles of chemotherapy. On physical examination, there is tender swelling of the right calf without erythema. His D-dimer is 640 ng/mL. Venous Doppler of the right leg reveals occlusive thrombi in the deep veins. A plan is made to initiate anticoagulation and to extend the treatment for 6 months.What will be the drug of choice for anticoagulation for this patient? | options: A: Rivaroxaban B: Low-molecular-weight heparin C: Warfarin D: Low dose aspirin (81 mg/d) | answer: B </s> |
<s>[INST] context: Trip 1 Black bear Count
There have been fires in this area in the last few years and the Office of the National Park is not sure how many black bears are still living. Some bears have been seen since the fires, and the Office has asked for young people to help count them. The entire trip will last three hours. Bookings necessary.
Cost: Free When: May 8
Trip 2 Garland Valley
Bring your drink and lunch for this walk in a beautiful area of the Blue Mountains. Garland Valley is close to the town of Garland but is part of the National Park. Many wild animals live in this area, including many rare birds. This is a great walk for bird-lovers. The trip lasts four hours. Bookings necessary.
Cost: $15 When: May 8, May 15
Trip 3 Flashlight Adventure
Put on your warm clothes, bring a flashlight and a pair of glasses, and come for a night walk along the Dungog Valley, part of the National Park. A guide will lead the tour. Many of the animals you will see on this trip. The guide will tell you about the lives of the animals you see. Numbers are strictly limited on night trips, so be sure to book early. This walk lasts two and a half hours.
Cost: $12 When: May 8, May 15, May22
Equipment to be needed:
Please bring enough water and food for all walks.
Wear good walking shoes---no high heels.
Wear a hat for day walks.
Dress warmly for night walks.
Children must be with an adult.
Make sure your flashlight works well and bring extra batteries for night walks.
Follow all instructions from guides during the walks. The mountains are a dangerous place.
Bookings:
Bookings for the above trips can be trade by telephone (893 m 4847) or on the Internet at www. Blue mountain tour. com [/INST] question: These trips are | options: A: In a park in the mountains B: In a large city C: In a special kind of zoo D: In three different countries | answer: A </s> |
<s>[INST] context: Chinese writer Mo Yan has won the 2012 Nobel Prize in Literature . He is the first Chinese who lives and works in China to win the prize.
Mo Yan, the pen-name for Guan Moye, was bom in 1955 and grew up in Gaomi in Shandong province in eastern China. His parents were farmers. He left school to work at the age of 12, first on the farm, later in a factory. In 1976 he joined the PLA and during this time he began to study literature and writing. His first short story was published in 1981.
He has written many famous books about his childhood and his hometown. The novel Honggaoliang jiazu is one of them. It tells five stories that took place in Gaomi during the 1930s and 1940s. The book was published in 1987 and translated into English in 1993. It was made into a popular movie in 1987 by the well-known director Zhang Yimou.
Besides his novels, Mo Yan has published many short stories and essays . He is regarded as one of the greatest writers in China. Many of his books have been translated into English, French and many other languages.
The Nobel Prizes were set up by Alfred Nobel, a great Swedish inventor, in 1895. The winner will win a medal, a diploma and a cash award of 8 million Swedish Kronor (about 7 million yuan). [/INST] question: When did Mo Yan leave school to work on the farm? | options: A: In 1955 B: In 1967 C: In 1976 D: In 1981 | answer: B </s> |
<s>[INST] context: Smith was a landlord . He loved money very much and never gave anything to anybody. Soon he became rich. One day the weather was fine. There wasn't a cloud in the sky and the sun was very warm. The landlord was walking along a river with his friends, when, all of a sudden, he slipped and fell into it. He cried, "Help! Help!" One of his friends held out his hand and said, "Give me your hand and I will pull you out." The landlord's head went under the water and then came up again, but he did not give his hand to his friends. Then another of his friends tried but the same thing happened. Just then a farmer came over and saw all this. He knew the landlord very well. He said to the others, "Let me try." He held out his hand and said to the landlord," Take my hand and I will pull you out." Hearing this, the landlord took the farmer's hand, and in a minute the farmer pulled the landlord out of the water. All the others got very surprised at this and asked the farmer, "Why did he give his hand to you but not to us?" The farmer said, "You don't know your friend very well, When you say 'give' to him, he does nothing, but when you say 'take', he takes." [/INST] question: Smith was a _ . | options: A: doctor B: farmer C: landlord D: waiter | answer: C </s> |
<s>[INST] context: After a fight and before forgiveness often comes an apology. But saying "I'm sorry" comes more easily for some people than doing that for others. A new study suggests that specific personality traits offer clues about whether a person is likely to offer a sincere apology.
Psychologist Andrew Howell and his colleagues at Grant MacEwan University in Edmonton designed a questionnaire to measure a person's willingness to beg someone's pardon. They asked participants to indicate their level of agreement with a series of statements, such as "My continued anger often gets in the way of me apologizing" or "If I think no one will know what I have done, I am not likely to apologize." The researchers then used the answers to determine every participant's "proclivity to apologize," and they cross-referenced these scores with results from a variety of personality assessments.
From the beginning, Howell was confident that people with high marks on compassion and agreeability would be willing apologizers -- and the study results confirmed his hypothesis . But the experiment also turned up some surprising traits of the unrepentant .
People with low self-esteem, for example, were less inclined to apologize, even though they probably feel bad after a conflict. Unlike people who experience guilt about a specific action and feel sorry for the person they have wronged, individuals who experience generalized shame may actually be feeling sorry for themselves.
In contrast, "people who are sure of themselves have the capacity to confess to wrongdoing and admit it," Howell suggests. But just the right amount of self-esteem is the key. The study also found that narcissists -- people who, in Howell's words, "are very egocentric, with an overly grand view of themselves" -- were reluctant to offer an apology.
The researchers were most surprised to find that a strong sense of justice was negatively correlated with a willingness to apologize, perhaps suggesting that contrition and an "eye for an eye" philosophy are incompatible . Reconciliation may end a conflict, but it cannot always settle a score. [/INST] question: What method did Andrew Howell and his colleagues use in the study? | options: A: Observing people B: Interviewing people C: Doing lab experiments D: Collecting information | answer: D </s> |
<s>[INST] context: Do you like to sit in front of the computer and play computer games hour after hour? Have you ever thought of what that may be doing to your health? More and more children are becoming overweight and growing less creative because they spend too much time in front of the computer according to a survey.
Last week Child Protective Services in America organized an activity. The aim of the activity was to encourage children to do some outdoor activities instead of playing computer games at home. Many American children spend about 1,000 hours a year playing computer games -- more time than they spend in school. As a result, they are overweight. Some of them have very poor _ , and they can't see clearly.
Everyone should pay attention to his health and try to keep healthy. The doctor says that the longer children play computer games, the more overweight they may become. And the junk food children eat while they're playing computer games makes the weight problem more serious.
To keep fit, children need to take exercise regularly, play outside with friends, and explore the world around them. Can you spend two weeks without playing computer games? It might be difficult for computer lovers, but why not have a try? [/INST] question: Children may become _ if they play computer games all day. | options: A: much younger B: much lighter C: less creative D: less careful | answer: C </s> |
<s>[INST] context: It was a sunny night. Jim was having a drink with his friend. He drank too much, and he had to leave at half past eight because he had a ticket for a music festival, which would start at nine o'clock.
It was half past an hour's walk from the pub to the theatre. Jim knew a _ that would only take ten minutes, but it meant crossing rails , and was dangerous. He took the shorter way, however, and when he reached the rails, he tripped and fell over. Then he fell asleep with his face down. After a while, a train came. When the driver saw a body lying on the track, he tried hard to stop the train. When it finally stopped, it was several meters before the body. The driver quickly got off and checked. Luckily, he found the man was still alive, but sleeping. Though the driver tried hard to wake him, Jim just kept sleeping. The driver took Jim to the hospital, where he woke up at last.
When Jim was told what had happened, he decided to give up drinking. "I'm so lucky that I have a chance to turn my life around,' he said. [/INST] question: Where did Jim and his friends have a drink? | options: A: In a hospital B: In a pub C: At a theatre D: In a hotel | answer: B </s> |
<s>[INST] context: Thyrotoxicosis is a hypermetabolic state caused by elevated circulating levels of free T3 and T4 . most commonly caused by hyperfunctioning of thyroid gland, therefore it is often referred as hypehyroidism. However, in ceain conditions the oversupply is related to either excessive release of preformed thyroid hormone (e.g., in thyroiditis) or to an extrathyroidal source, rather than hyperfunctioning of gland. Disorder Associated with Thyrotoxicosis: Associated with Hypehyroidism Not associated with hypehyroidism - Primary: Diffuse hyperplasia (Graves' disease) Hyper functioning ("toxic") multinodular goiter Hyper functioning ("toxic") adenoma Iodine - induced hypehyroidism Neonatal thyrotoxicosis associated with maternal Grave's disease - Secondary: TSH-secreting pituitary adenoma (rare) Granulomatous (de Quervain) thyroiditis (painful) Subacute lymphocytic thyroiditis (painless) Struma ovarii (ovarian teratoma with ectopic thyroid) Facititious thyrotoxicosis (exogenous thyroxine intake) [/INST] question: Disorder associated with thyrotoxicosis but not associated with hypehyroidism is: | options: A: Graves disease B: Hyperfunctioning ("toxic") multinodular goiter C: Iodine-induced hypehyroidism D: De Quervain thyroiditis | answer: D </s> |
<s>[INST] context: Celiac plexus is a sympathetic ganglion thus blocking it will always cause hypotension. The celiac plexus is the largest plexus of the sympathetic nervous system. It contains preganglionic sympathetic fibers from greater and lesser splanchnic nerves (emerge from the thoracic sympathetic ganglia, T5 to T12) as well as postganglionic sympathetic and preganglionic parasympathetic fibers. It provides sensory innervation and sympathetic outflow to stomach, liver, spleen, pancreas, kidney and GI tract up to splenic flexure. Plexus is located at the level of T12-L2 (usually L1) and lies anterior to aoa in the retroperitoneal space. Indications Most common indication is treatment of pain caused by pancreatic cancer. Occasionally used in the treatment of pain from chronic pancreatitis (controversial). Can be used for pain from other GI malignancies from LES to splenic flexure, as well as liver, spleen and kidneys. Complications Ohostatic hypotension (most common, can be minimized with fluid hydration) and diarrhea (secondary to blockade of sympathetic fibers). Less common complications include paraplegia (from damage to aery of Adamkiewicz), local anesthetic toxicity, spinal or epidural injection, aoic or vena cava puncture and bleeding, retroperitoeneal hemorrhage, visceral organ injury, and pneumothorax (if needle is placed too cephalad) Anatomical Considerations: preganglionic SNS (greater/lesser splanchnic nerves), postganglionic SNS, preganglionic PNS, sensory Indications: pancreatic cancer (common); sometimes pancreatitis (controversial) Common Side Effects: ohostatic hypotension, diarrhea Rare Side Effects: paraplegia, LA toxicity, spinal/epidural injection, aoic or vena cava puncture, retroperitoeneal hemorrhage, visceral organ injury, pneumothorax [/INST] question: Commonest complication of celiac plexus block is | options: A: Bradycardia B: Hypotension C: Seizures D: Retroperitoneal hematoma | answer: B </s> |
<s>[INST] context: Black Friday is the day following Thanksgiving Day in the United States.In recent years,it has been regarded as the beginning of the Christmas shopping season and most major shops have opened extremely early and offered promotional sales .Black Friday is not an official holiday,but many employees and schools have both Thanksgiving and the following Friday off,followed by a weekend.It has been the busiest shopping day of they ear since 2005.
The day's name began in Philadelphia,where it originally was used to describe huge crowds and heavy traffic that would occur on the day after Thanksgiving.The use of the name started before 1961.Later all alternative explanation was made:"Black Friday"indicates the point at which retailers begin to turn a profit or are"in the black".
For many years,it was common for retailers to open at 6:00 a.m.,but in the late 2000s many had opened at 5:00 a.m.or even 4:00 a.m..This was taken to a new degree in 2011,when several retailers opened at midnight for the first time.
Black Friday Shopping is known for attracting aggressive crowds,with annual reports of terrible noise and crowds of people trampling on other shoppers in an attempt to get the best deal on a product before supplies run out. [/INST] question: Black Friday originally referred to _ . | options: A: financial loss B: a busy shopping day C: heavy traffic and crowds D: sad feelings and moments | answer: C </s> |
<s>[INST] context: Since 1936, many female space explorers have followed Russian astronaut Valentina Tereshkova. Let's look at the missions of four important female astronauts to find out what astronauts do in space.
In 1983, Sally Ride became the first American women in space. Her team carried out scientific experiments in space and put two communications satellites in space. Satellites make it possible for us to communicate instantly with each other across the world through TV, radio, and telephones.
In 1984, Kathryn Sullivan became the first American women to walk in space. During her mission, she discovered important information about the sun's energy and how it affects the climate in very hot and very cold places on Earth. She also took photographs of Earth and measured air pollution.
In 1992, Mae Jemison became the first African-American in space. During her mission, she did scientific experiments using the weightless atmosphere. In space, there is no gravity, so everything floats! Dr. Jemison's experiments gave important information about the human body to produce better medicines and healthcare.
In 2012, Liu Yang became the first Chinese women in space. She did experiments in space medicine, which look at how astronauts can survive and stay healthy in space. The conditions in space are very hard on the body and space medicine helps astronauts work safely. [/INST] question: Who collected important information about air pollution? | options: A: Valentina Tereshkova B: Sally Ride C: Kathryn Sullivan D: Mae Jemison | answer: C </s> |
<s>[INST] context: The police do many things for us. They help keep our things and us safe. They help keep cars moving safely. They take care of people who are hurt. Then they see these people get to a doctor.
The police go around town to see that everything is all right. They get around town in many ways. Some of them walk or go by car. In some big cities,some of the police ride on horses. It is strange to see these animals in the street.
As they go around town,the police help people. Sometimes they find lost children. They take the children home. If the police see a fight,they put an end to it right away. Sometimes people will ask the police how to get to a place in town. The police can always tell the people which way to go. They know all the streets and roads well.
Some police stand at crossings. They tell the cars when to go and when to stop. They make sure that the cars do not go too fast. They help children cross the street. They also help people who can't walk too well.
Without the police,our streets would not be safe. Cars might go too fast and hurt people. Lost people might never be found. The police do a good job. We need them. And we should thank them for a job well done. [/INST] question: The police do many things for us. They help keep our things and us _ . | options: A: warm B: clean C: quiet D: safe | answer: D </s> |
<s>[INST] context: "Urine culture is mandatory before surgery and infection should be treated. The urine is collected by Catheterization."
In VVF
"Preoperative collection is best to be done through ureteric catheterization." So friends undoubtedly ureteric catheterization. (Don't get confused - it is not Foley's catheterization) is the best method for collecting urine for culture in a case of VVF. This option is not given, so, we will have to look for next best option.
"Urine collected through a sterile vaginal speculum will not serve the purpose because of contamination.
Midstream clean catch sample is also contaminated in vesicovaginal fistulas. (Option "b")
Supra pubic aspiration done after proper cleansing and draping the patient with full bladder, is easy and next best method of urine collection after ureteric catheterization. But the only prerequisite for this method of collection is 'A full bladder' which cannot be fulfilled in a case of VVF as urine continuously dribbles from the vagina and therefore, bladder is never full. (Ruling out Option "a")
By exclusion our answer is Foley's catheterization, although chances of contamination are present in Foley's catheterization but they can be reduced if proper vaginal douching is done prior to collection of urine. [/INST] question: The most appropriate method for collecting urine for culture in case of vesicovaginal fistula is: | options: A: Suprapubic needle aspiration B: Midstream clean catch C: Foley's catheterisation D: Sterile speculum | answer: C </s> |
<s>[INST] context: (c) Source: (Hay et al, pp 46-47, 602. Kliegman et al, pp 594-596. McMillan et al, pp 211-212. Rudolph et al, pp 209-211.) Diaphragmatic hernia occurs with the movement of abdominal contents across a congenital or traumatic defect in the diaphragm. In the newborn, this condition results in profound respiratory distress with significant mortality. Prenatal diagnosis is common and, when found, necessitates that the birth take place at a tertiary-level center. In the neonate, respiratory failure in the first hours of life, a scaphoid abdomen, and presence of bowel sounds in the chest are common findings. Intensive respiratory support, including high-frequency oscillatory ventilation and extracorporeal membrane oxygenation (ECMO), has increased survival. Mortality can be as high as 50% despite aggressive treatment. While surgery may correct the diaphragmatic defect, the lung on the affected side remains hypoplastic and continues to contribute to morbidity. Several fetal surgery centers are investigating surgical techniques to repair the hernia in utero to allow the affected lung adequate time to develop prior to delivery. Pneumonia and pneumothorax may cause respiratory distress with decreased breath sounds, but the radiograph in diaphragmatic hernia shows the nasogastric tube curving into the left thorax, clearly an abnormal placement. A congenital cystic adenomatoid malformation will frequently look like a diaphragmatic hernia on radiographs, but the nasogastric tube would be in the correct location. Choanal atresia is an upper airway abnormality and does not cause these radiographic changes; it would have been difficult to place the nasogastric tube in the first place with this condition, in which there is a bony or membranous septum between the nose and pharynx. [/INST] question: A newborn infant develops respiratory distress immediately after birth. His abdomen is scaphoid. No breath sounds are heard on the left side of his chest, but they are audible on the right. Immediate intubation is successful with little or no improvement in clinical status. Emergency chest x-ray is shown (A) along with an x-ray 2 hours later (B). Which of the following is the most likely explanation for this infant's condition? | options: A: Pneumonia B: Cystic adenomatoid malformation C: Diaphragmatic hernia D: Choanal atresia | answer: C </s> |
<s>[INST] context: Sir Steven Redgrave--Winner of 5 Olympic Gold Medals
"In 1997 I was found to have developed diabetes , believing the profession trained for the whole of my life ended, I felt very sorry. Then one of my friends said there was no reason why I should stop training. That was it--the encouragement I needed. I could still be a winner if I believed in myself. I am not saying that it isn't difficult sometimes. But I wanted to prove to myself that I wasn't finished yet. Nothing is to stand in my way."
Karen Pickering--Swimming World Champion
"I swim 4 hours a day, 6 days a week. I manage that amount of work by putting it on top of my diary. This is the key to success--you can't follow a profession in any field without being well-organized. Make a list of what you believe you can achieve. Trust yourself, write down your goals for the day, however small they are, and you'll be a step closer to achieving them."
Kristen Stewart--Actress
"When things are getting hard, a voice inside my head tells me that I can't achieve anything. Then, there are other _ , such as family or hobbies. The key is to give most of your attention to one thing. When I feel nervous, it helps a lot to repeat words such as 'calm', 'peace', either out loud or silently in my mind. It makes me feel more in control and improves my confidence. This is a habit and is a powerful psychological tool." [/INST] question: The same character of the three people is _ . | options: A: humour B: happiness C: self-confidence D: wisdom | answer: C </s> |
<s>[INST] context: In April this year, lots of bags full of small change were seen at bus stops in Tianjin. They were made for passengers to turn their notes into small change. And such an idea came from four students from Zhongbei Middle School, Tianjin.
"People will surely feel worried when they take a bus without coins. We just want to do something to help them," said Wang Yongcun, 15, one of the four students.
The four boys spent their whole weekend making the change bags. After that they went to see the number of the passengers at each bus stop near their school, and then chose the top six stops to put the bags.
Many people think that the four boys have really done a good job. But, things didn't go as the boys thought. Two days later, they found that the money was gone, and that even the bags were taken. It really made them sad but they would not give up. Their classmates and teachers came to help them in time. They put their pocket money in bags again. And the teachers also taught them to make better change bags. They tried their best to do it.
The four boys feel very happy because they have done something good for the passengers. Their warm hearts are moving. More and more people are beginning to join in the activity. [/INST] question: The change bags were put _ . | options: A: on the buses B: at the bus stops C: under the desks D: near the parks | answer: B </s> |
<s>[INST] context: Juvenile myelomonocytic leukemia (JMML) is a serious chronic leukemia (cancer of the blood) that affects children mostly aged 4 and younger. The name JMML now encompasses all diagnoses formerly referred to as juvenile chronic myeloid leukemia (JCML), chronic myelomonocytic leukemia of infancy, and infantile monosomy 7 syndrome. The average age of patients at diagnosis is 2 years old. The World Health Organization has included JMML in the category of myelodysplastic and myeloproliferative disordersDiagnosis Edit The following criteria are required in order to diagnose JMML: All 3 of the following: No Philadelphia chromosome or BCR/ABL fusion gene. Peripheral blood monocytosis >1 x 109/L. Less than 20% blasts (including promonocytes) in the blood and bone marrow (blast count is less than 2% on average) Two or more of the following criteria: Hemoglobin F increased for age. Immature granulocytes and nucleated red cells in the peripheral blood. White blood cell count >10 x 109/L. Clonal chromosomal abnormality (e.g., monosomy 7). Granulocyte macrophage colony-stimulating factor (GM-CSF) hypersensitivity of myeloid progenitors in vitro. These criteria are identified through blood tests and bone marrow tests. Blood tests: A complete blood count (CBC) will be performed on a child suspected of having JMML and throughout the treatment and recovery of a child diagnosed with JMML. The differential diagnosis list includes infectious diseases like Epstein-Barr virus, cytomegalovirus, human herpesvirus 6, histoplasma, mycobacteria, and toxoplasma, which can produce similar symptoms. [/INST] question: Which of the following is not compatible with a diagnosis of juvenile myelomonocytic leukemia | options: A: Peripheral blood monocytosis, more than 1 x 10(9)\/L B: Increased hemoglobin F levels for age C: Presence of bcr\/abl fusion gene D: GM-CSF hypersensitivity of myeloid progenitors in vitro | answer: C </s> |
<s>[INST] context: Parents on South Australia's Aboriginal lands may lose some of their financial aid if they do not send their children to school. The new rules draw wide concern.
Mundine is Prime Minister Tony Abbott's top advisor on issues concerning Aboriginals, native Australians. "Now, I know the government needs some necessary measures but I think punishing the parents is really the last choice." Mr. Mundine says the situation can be changed if the tribal leaders support education. "We need to work with parents and communities because we are making a huge cultural change here." But other officials say they believe the threat of stopping aid will force families to take education more seriously.
The State of South Australia says it has special programs for Aboriginal children. The students work with their parents and teachers first to develop a personal learning plan and the public schools provide special workers to work individually with Aboriginal students. At the age of seven, Aboriginal students can join a program called Enter for Success designed to attract students to school. The students can choose which high school to attend and receive support in reaching the goals on their individual learning plans.
The State of Western Australia also has special programs for Aboriginal and other ethnic groups. The state operates a program called Focus Schools which centers on basic skills like reading, writing and counting. 67% of these public focus schools serve the students in 79 very rural areas. Most of them are primary schools. The Focus Schools program also includes 118 coaches working with students in 134 schools. [/INST] question: What's the aim of the new regulations? | options: A: To develop advanced education B: To improve Aboriginal children's school attendance C: To get tribal chiefs to support education D: To punish parents on South Australia's Aboriginal lands | answer: B </s> |
<s>[INST] context: Anne Sanders was practicing soccer moves, which was not normal. Usually, Anne only plays basketball. She wins every basketball game she plays, and she loses at any other game. "Anne", I waved to her. "Why are you playing soccer?"
"Well, the gym teacher is doing something different," she said. "There are teams of four and partners of two.We get to pick our partners, and I want someone to pick me. "Anne held up a list.
"It looks like I'm on a team with you, Stacey, and Paul," I said. "Stacey is my best friend.Maybe we can be together: " Just then, Stacey and Paul came over. They had heard of the teams.
"Do you want to be partners, Stacey?" I asked.
"Well, I was going to be partners with Paul," she claimed. I didn't blame her. Paul was as fast as a rocket, and my nickname was "Snail". "But we are best friends," said Stacey. "So I guess I'II be with you. "
It was our first game. Stacey went to talk to some other friends afterwards, and Paul and Anne were talking about winning their game. I was sipping on my water, when I overheard Stacey, "She's worse than I thought; if I played the team alone,, I would have won easily. She's worse than a snail. She's more like a statue. "
That night, I felt terrible for losing and mad at Stacey for calling me a statue. After all, she was my best friend and my only friend. Anyway, the phone rang, and it was Stacey. At first, I thought she might apologize, but no such luck.
"Allison, the game tomorrow is canceled, " she said.
"Okay," I replied. "Sorry about the game today", Stacey hung up on me.
The next day, I went over to the soccer field. I knew the game was canceled, but maybe I could help clean up.But instead of a mess, I saw a soccer game in progress. Stacey and were playing, and Anne was hiding in the corner. "Paul made me pretend to be sick, " she whispered. "He wants to play with Stacey because she's so fast. "
So Anne and I went to get ice cream. Even if I lost Stacey ,I just created a lifelong friendship. [/INST] question: Why did Anne practice playing soccer? | options: A: Because she wanted to win in all games B: Because she didn't want to be left out C: Because she intended to be a normal student D: Because she hoped to do something different | answer: B </s> |
<s>[INST] context: LNG intrauterine device Levonorgestrel alone, 0.75 mg stat F/B another 0.75 mg 12 hrs later, taken within 72 hrs of unprotected intercourse is the method of choice .for emergency contraception Emergency contraception is also k/a postcoital morning after contraception. Basically the methods used interfere with the physiological events before implantation, for e.g. inhibition or delaying of ovulation or interference with postovulatory events necessary for implantation & longevity of the blastocyst. Agents used for emergency contraception are known as 'interceptives'. Methods of emergency contraception Drugs Dosage Time frame Preg. rate * High dose estrogens (not used now) - Ethinyl estradiol (EE) 2.5 mg BD x 5 days Within 72 hrs of coitus -L. 0.15% - Conjugated equine estrogen (CEE) 15 mg BD x 5 days 0-0.6% * Estrogen & progestin combination pill - Yuzpe method EE 50 lag + d, 1-NG 0.5 mg (Ovral) 2 tabs stat & 2 tabs after 12 hrs (Total dose EE 0.2 mg & LNG 2 mg) " 0-2% - Low dose pills EE 30 lig + LNG 0 0.15mg (Ovral L, Mala-N etc.) 4 tabs stat & 4 tabs after 12 hors 0-2% * Levonorgestrel (LNG) alone (Ecee 2, i-pill, E-pill, unwanted-72, Plan-B) 0.75 mg stat FIB 0.75 mg after 12 hrs or 1.5 mg stat Preferably within 72 hrs but can be given upto 5 days 0-1% * Centchroman 30mg (Saheli) 2 tab BD x 1 day 400/800 x BD mg m 3 Within 5 days not known * Danazol days or 1200 mg BD x 2 days Within 72 hrs 0.8 - 1.7% * Mifepristone (RU 486) 600 mg/200 mg / 10 mg single dose Within 5 days to 27th day of cycle 1.3% * Copper HID (more effective than s steroids) ) To be inseed within 7 days < 1% [/INST] question: Not used in emergency contraceptions aEUR' | options: A: LNG intra uterine device B: Oral mifepristone C: Oral levonorgesterol D: Cu T intrauterine device | answer: A </s> |
<s>[INST] context: Welcome to the Ambassador Hotel. To make your stay as enjoyable as possible, we hope you can make full use of our facilities .
Dining Room
Breakfast is served in the dining room from 8 a.m. to 9:30 a.m. The room staff will bring a breakfast tray to your room at any time after 7 a.m. Please fill out a card and hang it outside your door when you go to bed.
Lunch: 12:00 a.m. to 2:30 p.m.
Dinner: 7:30 p.m. to 9:00 p.m.
Room Service
This operates 24 hours a day; phone the Reception Desk, and your message will be passed on to the room staff.
Telephones
To make a phone call, dial 0 for Reception and ask to be connected. We apologize for delays in putting calls through when the staffs are very busy. There are also public telephone boxes near the Reception Desk. Early calls should be booked with Reception.
Laundry
We have a laundry in the hotel, and will wash, iron and return your clothes within 24 hours. Ask the room staff to collect them.
Bar
The hotel bar is open from 12 a.m. to 2 p.m. and 7 p.m. to 1 a.m. [/INST] question: You would see this notice _ . | options: A: in a hotel bar B: in a hotel dining room C: in a bedroom of a large hotel D: in the entrance of a small family hotel | answer: C </s> |
<s>[INST] context: Chemical conjunctivitis Time of onset of chemical conjuctivitis: Immediately after bih Ophthalmia Neonatorum *B/L Conjunctival swelling in a neonate in first 4 weeks of life Signs Pain and tenderness in the eyeball. Conjunctival discharge Conjunctiva shows hyperaemia & chemosis. Eyelids are usually swollen. Corneal involvement may occur in herpes simplex ophthalmia neonatorum. CAUSES Chlamydia trachomatis Neisseria gonorrhoeae Haemophilus species Streptococcus pneumoniae Staphylococcus aureus BACTERIAL Staphylococcus epidermidis Streptococcus viridans Escherichia coli Pseudomonas aeruginosa VIRAL Adenovirus Herpes simplex virus CHEMICAL CONJUNCTIVITIS Crede's solution Time of Onset *Chemical : Immediately *C. Trachomatis: upto 2 weeks *N. Gonorrhea: 24-48 hours *Staphylococcus, H. influenzae, Streptococcus, enterococcus: 2-5 days *Viral: within one week Just on the basis of the time of onset, it is difficult to make a diagnosis sometimes, other relevant clinical history and clinical findings have to be taken in consideration [/INST] question: Ophthalmia neonatorum presenting within 24 hours of bih is most likely due to | options: A: Chemical inoculation B: Herpes simplex C: Staphylococcus D: H. Influenzae | answer: A </s> |
<s>[INST] context: When you're returning to Australia, be careful that you don't bring in pests and diseases. Some items you might bring back from overseas can be pests and diseases that Australia doesn't have. When you return, declare all food, meat, fruits, plants, seeds, wooden souvenirs, animal or plant materials.
Australia has strict quarantine laws and tough on-the-spot fines. Every piece of luggage is now screened or X-rayed. If you fail to declare any quarantine items, or if you make a false declaration, you will get caught. In addition to on-the-spot fines, you could be accused and fined more than $60, 000 and you may risk 10 years in prison. All international mail is also screened.
Some products may require treatment to make them safe. Items that are restricted because of the risk of pests and diseases will be seized and destroyed by the Australian Quarantine and Inspection Service(AQIS).
In many cases, the goods you declare will be returned to you after inspection. However, any item that presents a quarantine risk will be withheld . You will be given a range of options for each item depending on the quarantine risk:
Treating the item to make it safe;
Holding the item until an import permit is presented*; *
Re-exporting the item;
Destroying the item.
Those treatments with the sign "*" are subject to fees.
Further information:
For more detailed information about bringing in food, animals, plants, animal or plant materials, call the AQIS at 1800-020-504. [/INST] question: Which of the following don't you need to declare when returning to Australia? | options: A: Tea B: Wooden combs C: Some bread D: A pair of glasses | answer: D </s> |
<s>[INST] context: In almost every big university in the United States football is a favorite sport. American football is not like soccer.
Players sometimes kick the ball, but they also throw the ball and run with it. They try to take it to the other end of the field. They have four chances to move the ball ten yards. They can carry it or throw it. If they move it to the end of the field, they receive six points. This is called a touch--down. It is difficult to move the ball. Eleven men on the team try to stop the man who has the ball. If the man does not move the ball ten yards, his team kicks the ball to the other team.
Each university wants its team to win. Thousands of people come to watch. They all yell for their favorite team. Young men and women called cheerleaders come on the field to help the people yell more. They dance and jump while they yell.
Each team plays ten or eleven games each season. The season begins in September and ends in November. If a team is very good, it may play another game after the season ends. The best teams play again on January 1st, the first day of the New Year. Many people go to see these games and many others watch them on television [/INST] question: In American football players can _ . | options: A: only kick the ball B: only throw the ball C: only carry the ball D: kick, throw and carry the ball | answer: D </s> |
<s>[INST] context: ref Robbins 7/e p73,9/e p98 It is also seen in wegener's granulomatosis. Caseous necrosis is a form of cell death in which the tissue maintains a cheese-like appearance. The dead tissue appears as a soft and white proteinaceous dead cell mass. CausesEdit Frequently, caseous necrosis is encountered in the foci of tuberculosis infections. It can also be caused by syphilis and ceain fungi. A similar appearance can be associated with histoplasmosis, cryptococcosis, and coccidioidomycosis. AppearanceEdit In caseous necrosis no histological architecture is preserved. On microscopic examination with H&E staining, it is characterized by acellular pink areas of necrosis surrounded by a granulomatousinflammatory process. When the hilar lymph node for instance is infected with tuberculosis and leads to caseous necrosis, its gross appearance can be a cheesy tan to white, which is why this type of necrosis is often depicted as a combination of both coagulative and liquefactive necrosis. However, in the lung, extensive caseous necrosis with confluent cheesy tan granulomas is typical. The tissue destruction is so extensive that there are areas of cavitation (also known as cystic spaces). See Ghon's complex [/INST] question: Caseous necrosis in granuloma are not found in | options: A: TB B: Leprosy C: Histoplasmosis D: CMV | answer: B </s> |
<s>[INST] context: This is a page from a college information handbook. It tells you where you can find several different college services and facilities .
Where To Find Help In The College
Here are the places of some important college services and facilities.
Rooms numbered 100-130 are on the first floor and those numbered 200-230 are on the second floor of the main college buildings.
Students Services Center
Careers 113
The officers can offer you some advice on career choice and applications for higher education.
Accommodation Office 114
Mrs. J Mardle is here each afternoon from 1:30 to 4:30 to help students with housing problems.
Medical Room 115
Mrs. J Wright, the college nurse, helps you each morning from 9:30 to12:00 am.
The college doctor is on duty at the room on Wednesday mornings.
Sports office 207
Mrs. B Murie can provide information about sporting and keep-fit activities.
Student Union Office 222
A range of services and advice (travel etc.) is provided.
Food service 127
Mr G Nunn is the manager and will do his best to help if you ask for a special diet.
Library 215
Besides books this also has photocopying, video, audio-visual and computing facilities.
Self Access Language Learning Center 203
Students can attend on a drop-in basis from 9:00 am to 4:15 pm. [/INST] question: Where should you go for help if you fail to find a place to live in? | options: A: Room 114 B: Room 207 C: Room 222 D: Room 113 | answer: A </s> |
<s>[INST] context: Green is an important color in nature. It is the color of grass and the leaves on trees. It is also the color of most growing plants.
Sometimes, the word "green" means young, fresh and growing. For example, a greenhorn is someone who has no experience. In the 15th century, a greenhorn was a young cow or an ox whose horns had not yet developed. A century later, a greenhorn was a soldier who had no experience in war. By the 18th century, a greenhorn had the meaning it has today--a person who is new in a job.
Someone who is good at growing plants is said to have a green thumb . The expression comes from the early 20th century. A person with a green thumb can make plants grow quickly and well.
Green is also the color used to describe the powerful feeling , jealousy . The green-eyed monster is not a dangerous animal from outer space. It is an expression used about 400 years ago by the British writer William Shakespeare in his play "Othello". It describes the unpleasant feeling when someone has something he wants. For example, a young man may suffer from the green-eyed monster if you get a pay rise and he does not.
In most places in the world, a green light means to move ahead. In everyday speech, a green light means agree to continue with a project. [/INST] question: A greenhorn now refers to _ . | options: A: a person who is new in a job B: a new soldier C: a young horse D: a cow without horns | answer: A </s> |
<s>[INST] context: Hangzhou, capital of Zhejiang Province, China, was chosen to be the host city of the 19th Asian Games . However, some people say that the 19th Asian Games will be held in 2022, while some say 2023. Which is true?
To make it clear, we need to have a better understanding of Asian Games first.
The Asian Games is a multi-sport event. It is held every four years among athletes from all over Asia. It is the second largest multi-sport event after the Olympic Games.
The Asian Games are always held at the same year as the World Cup, which is also held every four years. Many people around the world pay more attention to the World Cup. This really makes the Olympic Council of Asia(OCA) worried. So, the OCA decides to _ the 18th Asian Games for a year. That is in 2019. In this way, the Asian Games won't be held in the same year as the World Cup. So Hangzhou will hold the event in 2023.
Hanoi , capital of Vietnam , is the host city of the 18th Asian Games. However, Vietnamese government announced in 2014 that Hanoi gave up the right to host the Asian Games because they don't have enough money.
Luckily, Djakarta , capital of Indonesia , was willing to be the host city instead of Hanoi. But then came another problem. Djakarta will hold presidential election in 2019, so the government wanted to change the holding time of the Asian Games back to 2018. The OCA agreed. [/INST] question: The 19th Asian Games is to be held in Hangzhou, capital of Zhejiang in _ . | options: A: 2023 B: 2022 C: 2019 D: 2018 | answer: A </s> |
<s>[INST] context: What's your opinion about gun control in the US?
Figures tell a different story: Countries that allow their citizens to carry guns seem to have more killings than those that do not allow them. It's easy to kill with a gun. The media is filled with violence. People, especially young people, watch television. Having a gun does not cause someone to kill. The problem is within that person's mind. Controlling guns will not control killing. Changing the mindset will, however.
--- Bobby Walker, U.S.
Guns are deadly to all others who are near or know someone who has one. People don't understand the danger it holds, and don't realize what will happen just by cleaning it of if a younger child gets a hold of it. This weapon is dangerous and we don't need teens, kids, anyone to have them. Society can get along without guns.
---Ann Miller, U.S
I have a very large farm near Austin, Texas, USA. Because it is far from the city, I need to protect my property and cattle from thieves and wild dogs. The wildlife, such as coyotes and puma , can feed on deer, mice, rabbits--they don't bother me and I don't bother them. I lost 45 animals to thieves that cut a fence. This will never happen again. You ask if I would shoot--of course--that's why I carry a gun.
--- Texas Rancher, U.S
Some people think guns are very bad because they lead to violence. In my opinion, when people kill themselves or others, they do not have any feelings because they do not know anything about love, sympathy , and promise. The only way those persons can get these feelings is when they keep close to family, friends and people who matter to them. Now, having a gun is not a problem: the problem is what the people feel when they use one.
---Connie Faille, Colombia [/INST] question: Bobby Walker's attitude towards the media might be _ | options: A: satisfied B: unconcerned C: doubtful D: negative | answer: D </s> |
<s>[INST] context: My Left Foot (1989)
Imagine _ , unable to make any movements except to move your left foot. The main character in My Left Foot,based on the real story of cerebral palsy sufferer Christy Brown,can barely move his mouth to speak, but by controlling his left foot, he's able to express himself as an artist and poet. For his moving performance of Brown, Daniel Lewis won his first Academy Award for best actor.
Shine (1996)
Do you have a talent you're afraid to share with the world? David Helfgott seemed meant from childhood to be "one of the truly great pianists," but the pressures of performing (and pleasing his father) resulted in a complete breakdown. Ten years in a mental hospital didn't weaken Helfgott's musical gift: When he was rediscovered, he was playing concertos in a bar. Shine received seven Oscar nominations , and Geoffrey Rush won best actor for his performance of Helfgott.
Life Is Beautiful (1997)
Nothing's more powerful than the love between a parent and a child. In this heartbreaking Italian film, a father (Roberto Benigni) makes an unbelievable sacrifice for his 4-year-old son: trapped in a Nazi concentration camp in 1945, the Jewish man convinces his boy that they are playing a complicated game. He manages to spare him the horror of the terrible war, and even in his final moments of life, keeps his son smiling and hopeful. Benigni won the best actor Oscar.
Stand and Deliver (1988)
Few people can inspire us more than a good teacher. Jaime Escalante (Edward James Olmos got Oscar nomination for best actor) is a great one. Employed at a high school where kids are expected to fail, Escalante challenges his math students to struggle for better things, like getting good grades in the AP exam. Despite the obstacles in their lives, the classmates achieve their goals, thanks to Mr. Escalante's support. The real Jaime Escalante, the Best Teacher in America, says that Stand and Deliver is "90% truth, 10% drama." [/INST] question: If you want to watch a movie about wars, which may be one of your choices? | options: A: Life Is Beautiful B: Stand and Deliver C: Shine D: My Left Foot | answer: A </s> |
<s>[INST] context: There is a time when Karyn Bosnak couldn't pay a $59 bill at the grocery store. She was officially broke. She didn't have enough money to get on the subway, but she looked rich. She was a television producer, earned $900 a week, and had a closetful of designer labels like Gucci and Louis Vuitton. But she also had a $20,221.40 credit card bill and an empty bank account. Karyn decided that it was time for a change. She built a website and simply asked people to help her out by sending her a dollar or two.
On the site, Karyn honestly explained her situation. "If 20,000 people gave me just $1, I'd be home free." Amazingly, it worked. Her website was visited by more than a million people. Although most donors just gave a few dollars, one generous donor sent $1,000. She was on TV and in newspapers and magazines. She was offered a book deal and a movie contract. And of course, she was able to pay off her credit card debt. She also sold her designer clothes on eBay. In her closet, where the Gucci purse once sat, Karyn keeps all the letters that people have sent her.
It's hard to understand why so many people helped a total stranger pay off her huge credit card bill. Karyn explains, "I was just honest about what happened; I didn't make up some sob story about saving the world." Her donors think it's funny and original, and view it less as a charity than as an entertainment site. Imitators have appeared all over the Internet, some with extremely selfish requests for things like a BMW or a house.
Actually, Karyn was not the first person to put up a website asking strangers for money. The practice has a name: "cyber-begging." Most sites receive little traffic and even less cash. Karyn also had thousands of enemies and critics. People sent her hate mail and scolded her on websites. Karyn says she never let this anger bother her. "They are probably jealous they didn't think of it." She explains. [/INST] question: Why was Karyn in financial trouble? | options: A: She lost her job B: Her business failed C: She spent too much money D: Her bank account was stolen | answer: C </s> |
<s>[INST] context: Tropical pyomyositis, a disease often seen in tropical countries, is characterised by suppuration within skeletal muscles, manifesting as single or multiple abscesses. The most common organism implicated is Staphylococcus aureus. In 20%-50% of cases there is a history of trauma to the affected muscles. Commonly involved muscles are quadriceps, glutei, pectoralis major, serratus anterior, biceps, iliopsoas, gastrocnemius, abdominal and spinal muscles. Early diagnosis is often missed because of lack of specific signs, unfamiliarity with the disease, atypical manifestations, and a wide range of differential diagnosis. Diagnostic techniques like ultrasound and computed tomography/magnetic resonance imaging are very useful in diagnosis. The diagnosis is confirmed either by biopsy or aspiration of pus from the affected muscles. The initial antibiotic of choice is cloxacillin. Incision and drainage are important components of management. Treatment for Gram negative or anaerobic organisms should be instituted, whenever indicated. Physicians should become more familiar with this potentially life threatening but curable infective disease entity. [/INST] question: Which is the most common micro-organism known to cause tropical pyomisitis? | options: A: Streptococcus viridans B: Staphylococcus albus C: Klebsiella pneumoniae D: Staphylococcus aureus | answer: D </s> |
<s>[INST] context: The incidental adrenal mass is seen in as many as 1.3% of abdominal CT scans performed for other reasons. Adrenocoical adenomas are most common, followed by adrenocoical carcinoma, metastases from other primary cancers, and pheochromocytoma. Biochemical evaluation must weigh the prevalence of adrenal neoplasms against the consequences of a missed life-threatening diagnosis, as in pheochromocytoma. All adrenal masses should be evaluated for pheochromocytoma with measurement of 24-hour urine catecholamines and their metabolites. Aldosterone and coisol measurement are indicated if clinical features suggest aldosteronism or Cushing's syndrome. Fine-needle aspiration of adrenal masses is indicated for clearly cystic lesions or if metastasis is suspected based on the presence of another known primary. Fine-needle aspiration is not routinely indicated in the evaluation of adrenal lesions and is contraindicated until pheochromocytoma is definitively excluded. Adrenal lesions should be resected if they are functional, are larger than 6 cm., or have enlarged during follow-up. [/INST] question: Incidental adrenal masses: | options: A: May be seen in as many as 10% of abdominal CT studies B: Most commonly represent pheochromocytoma; adrenocoical adenoma, adrenocoical carcinoma, and metastases from other primary cancers occur less frequently C: May represent adrenocoical carcinoma if greater than 6 cm. in diameter D: Should be routinely evaluated by measurement of 24-hour urine levels of catecholamines and their metabolites, coisol, and aldosterone plus fine-needle aspiration | answer: C </s> |
<s>[INST] context: The next generation telephone is called Superphone or personal Communication Network (PCN). Your superphone goes wherever you go, in your pocket. You can use it in the street, in an aeroplane, a boat, or a taxi; you can call from anywhere on the globe to anywhere else. Calls travel at the speed of light, via satellites using ultraviolet, high-frequency wave bands and each communication is automatically billed to your account.
This new phone is the size and shape of a billfold . You unfold it to use it., making it long enough to reach from your ear to your mouth. There is a miniaturized touch pad, on which to enter the number you are calling. There is also a tiny liquid crystal screen on which you can read weather, news or financial reports. These news items are constantly updated by the company that sells the service. Letter keys on the touch pad also allow you to use this electronic marvel as a computer or word processor. You can plug it into your large home or office computer in order to transfer any data that you feed in during a business trip. The PCN also stores any useful information of your own that you might need as you travel, such as the names, addresses and phone numbers of several hundred people, important meetings, flight details and so on. When you need information, you simply call it up on the screen. You can even use your PCN to activate electronically controlled equipment at home. For example, you could switch your oven on or off, start the sprinkler system in your garden during a dry spell, get your video recorder to record a show on television, turn off the central heating, and so on. All of this from thousands of miles away, perhaps from the back of a camel in the desert. Prototypes are already being trialed. In spite of the complex technology, they will be cheap because of the enormous sales that will be made. [/INST] question: The Superphone system _ . | options: A: has a very wide coverage of signals B: deducts fees directly from users' bank account C: offers a nearly free communicating service D: requires people to speak quickly | answer: A </s> |
<s>[INST] context: Most respected scientists agree that we need to find another source of energy- and quickly. If we continue to burn oil and pump carbon into the atmosphere, then the effects on global climate will lead to global disasters even before the oil disappear.
The British government has set a target of a 20 percent reduction in carbon emission by 2010. Central to this policy is the search for alternative, renewable forms of energy production---and this is where the serious disagreement among scientists begins.
Here, two people active in the debate about wind farms give their points of view.
Simon Shearman
"First, a few facts about wind power. Wind is one of the cheapest of the new, renewable forms of energy. It is extremely safe---no member of the public has ever been injured at a wind farm. The shallow waters around Britain are the windiest in Europe---ideal locations for wind farms and, by 2010, up to ten percent of the electricity used in the UK could be produced by wind power. I find it annoying and frustrating that the biggest objection that opponents of wind farms can come up with is that the crisis of global warming is real and something must be done urgently."
Alice Evans
"The simple, obvious fact is that wind turbines cannot generate electricity if the wind is too light or too strong and it often is. Many scientists estimate that wind turbines generally produce only 30 percent of their capacity . This is not a reliable enough supply to enable us to close down conventional power stations. In fact, wind power can't keep up with the growth of the demand for electricity, let alone replace other sources of power."
It's a topic that is causing heated debate around the country---but one we must address before it's too late---before the oil runs out. [/INST] question: Many scientists have different opinions on the search for a renewable energy because _ . | options: A: they think fossil fuels are everlasting B: British government's target is not realistic C: they are not sure in finding the clean and renewable energy D: the technology is not advanced enough | answer: C </s> |
<s>[INST] context: High specificity All are impoant attributes of screening test but among them high specificity is less impoant as Park states -'Screening test is not intended to be a diagnostic test. It is only an initial examination. Those who are found to have positive test results are refen-ed to a physician for fuher diagnostic work-up & treatment. High specificity is a necessary attribute for a diagnostic test. Below are given the differences between screening and diagnostic tests. Screening test Diagnostic test * Done on apparently healthy Done on those with indications or sick (asymptomatic) * Applied to groups Applied to single patients, all diseases are considered * Test results are arbitrary and final Diagnosis is not final but modified in light of new evidence, diagnosis is the sum of all evidence 4. Based on one criterion or cut-off Based on evaluation of a number of symptoms, signs and point (e.g., diabetes) laboratory findings Less accurate More accurate 6. Less expensive More expensive 7. Not a basis for treatment Used as a basis for treatment 8 The initiative comes from the investigator or agency providing care The initiative comes from a patient with a complaint Criteria for Screening test Screening test must satisfy the criteria of - acceptability - repeatability - validity - simplicity - safety - rapidity - ease of administration - low cost 1. Acceptability - Considering that screening tests are applied on asymptomatic people in large numbers, a high rate of people cooperation is needed. Thus the tests should be acceptable to the people. In general, tests that are painful, discomfoing or embarrasing (eg. rectal or vaginal examinations) are not likely to be acceptable to the population in mass campaigns. 2. Repeatability (Precision or reproducibility) - means that the test must give consistent results when repeated more than once on the same individual or material under the same conditions. 3.Low cost - A screening should be inexpensive. As a screening test has to be applied on millions of people to identify a small percentage who have early disease or its precursors, an expensive test however good, cannot justify use of restricted financial resources that has to be used for fuher diagnostic workup and t/t of those screened on positives. 4. High safety margin - This is an attribute of any test, whether diagnostic or screening. Moresoever for screening as screening tests are to be applied on millions of asymptomatic people and any adverse effect would bring whole process into disrepute. iims IN/nee answers & explanations -- May 2007 5. Validity - It expresses the ability of a test to separate or distinguish those who have the disease from those who do not - Validity has two components - sensitivity & specificity - An ideal screening test should be both highly sensitive and highly specific. But this is seldom possible and a compromise has always to be made. [/INST] question: Which of the following characteristics is not of much impoance in a screening test | options: A: Low cost B: High safety margin C: High sensitivity D: High specificity | answer: D </s> |
<s>[INST] context: Johnny lived with his mother and father in a small town in the mountains
One day there was an earthquake near the town. Many houses were damaged . Everyone thought that there would soon be another earthquake.
They were worried that the second earthquake would be worse than the first.
"We must send Johnny to a safe place," Johnny's mother said to her husband. "Many of our friends are sending their children to relatives in other towns,'
"We'll send him to my brother, Peter," Johnny's father said. "He lives a long way away. Johnny will be safe with him.'
He telephoned Johnny's Uncle Peter and asked him if he would let Johnny live with him.
"He's a good boy," he said. "He won't give you any trouble.'
"All right,' Johnny's Uncle Peter said, "but I'm not used to children. I live a very quiet and peaceful life."
"You won't know Johnny's in the house," his father told him.
So Johnny, who was five, went to live with his uncle.
Two days later, his mother and father received a telegram from Peter.
It said: "I am returning the child. Please send an earthquake." [/INST] question: Where did Johnny and his parents live? | options: A: in a big town B: near the sea C: in the mountains D: with his Uncle Peter | answer: C </s> |
<s>[INST] context: Until a few months ago, he was a butler in one of the more expensive residential buildings in Manhattan. But now, Nepal-born Indra Tamang is the owner of two multi-million dollar apartments in the same building.
The former owner - his former employer, Ruth Ford - died last year and left the apartments to Mr Tamang in her will.
Mr Tamang is happy but quickly points out that his good fortune did not come easily. "I am happy and have been touched by the generosity of the Ford family," he says. "I never expected that I will be given the ownership of these apartments. But I have been working for the family for the last 36 years, devotedly, with honesty and dedication . So my hard work has been rewarded."
Mr Tamang was 21 when he was brought from Nepal by Charles Ford, a writer and a photographer. Mr Ford died in 2002; his sister, actress Ruth Ford, then took charge and told Mr Tamang that he was like a brother to her after Charles's death.
Mrs Ford died aged 98. During the last five years of her life, she lost her eyesight and also developed speech problems. Mr Tamang looked after her most of the time and took care of her medicines and food.
He also worked with Charles Ford on various photography projects, which he now wants to keep as the photographer's legacy . He hopes to organize exhibitions of Mr Ford's photographs and edit a book of his works.
Mr Tamang plans to sell the bigger, three-bedroom apartment to pay the taxes he owes to the government on his legacy. He says: "The rules of the building might be a problem, as they require a minimum monthly income to qualify to live as owner of apartments. I have my small house here but I am happy with it,"
Mr Tamang has learnt his lesson from the life of his employers and plans to use his money with great caution. "I think one should save money for old age. That's when you need it the most to get care," he says. [/INST] question: Mr Tamang treated the legacy as _ . | options: A: a reward B: a punishment C: business D: a gift | answer: A </s> |
<s>[INST] context: Do you want to visit Disney World? However, will you worry about your pet if you go to Disney World? To meet the needs of these people, a pet hotel has been built near the Disney World Resort in Florida.
The new pet hotel is named Best Friends Pet Care Resort and it is mainly open to dogs and cats. It has an area of 4,645m2. About 270 dogs and 30 cats can be kept there at the same time. Besides dogs and cats, it can also provide services for birds, pigs and rabbits. However, it can't take care of snakes and turtles now.
Best Friend Pet Care Resort is a very expensive hotel. There are several types of dog rooms, such as rooms with air-conditioners and VIP rooms. There is even a "private dog park". Owners can have a high-quality vacation with their dogs there. The cats are kept in the "Kitty City". The "Kitty City" is very comfortable and clean. Workers there will clean it once a day.
Apart from having good equipment, Best Friends Pet Care Resort also have other plans to meet the psychological needs of pets. Workers play music to the pets, walk with them, play with them and even read stories to them before they go to bed.
"We aim to make sure that pets will have a fun vacation here, just like their owners at Disney World," said the manager of the resort. [/INST] question: How many kinds of animals can be kept in Best Friends Pet Care Resort? | options: A: Three B: Five C: Six D: Seven | answer: B </s> |
<s>[INST] context: The recovery of tensile strength results from the excess of collagen synthesis over collagen degradation during the first 2 months of healing, and, at later times, from structural modifications of collagen fibers (cross-linking, increased fiber size) after collagen synthesis ceases.
'Recovery of Tensile Strength: Fibrillar collagens (mostly type I collagen) form a major portion of the connective tissue in repair sites and are essential for the development of strength in healing wounds. Net collagen accumulation, however, depends not only on increased collagen synthesis but also on decreased degradation. When sutures are removed from an incisional surgical wound, usually at the end of the first week, wound strength is approximately 10% that of unwounded skin.
Wound strength increases rapidly over the next 4 weeks, slows down at approximately the third month after the original incision, and reaches a plateau at about 70% to 80% of the tensile strength of unwounded skin. Lower tensile strength in the healed wound area may persist for life. The recovery of tensile strength results from the excess of collagen synthesis over collagen degradation during the first 2 months of healing, and, at later times, from structural modifications of collagen fibers (cross-linking, increased fiber size) after collagen synthesis ceases.'- Robbins 8/e p105-106 [/INST] question: The tensile strength of wound after laparoscopic cholecystectomy in a 30 years old woman depends upon: | options: A: Replacement of type 3 collagen B: Macrophage aetivity/snvasion C: Extensive crosslinking of tropocollagen D: Granulation tissue | answer: C </s> |
<s>[INST] context: IgA nephropathy or Berger's disease affects children and young adult and is perhaps the most frequent type of glomerulonephritis in children.
IgA nephropathy (Berger nephropathy)
It is the most common type of glomerulonephritis worldwide.
Children and young adults are commonly affected.
It occurs after an upper respiratory tract infection or gastrointestinal infection.
Clinical presentation
Gross hematuria within 1-2 days after on upper respiratory tract infection. This feature distinguishes it from PSGN. In PSGN hematuria occurs 7-21 days after respiratory infection.
Can also present with nephritic or nephrotic syndrome.
Mild to moderate hypertension.
Pathology
Focal and segmental mesangial proliferation.
IgA deposition in the mesangium.
Serum complement level is normal. This feature also differentiates it from PSGN. In PSGN complement (C3) level is decreased.
Whereas IgA nephropathy is isolated renal disease, similar IgA deposits are also found in systemic disorders of children like Henoch shonlein purpura, which also has renal vasculitis as a component fit view of the high frequency of IgA nephropathy in children, IgA can be used as a marker for renal vasculitis. [/INST] question: Marker for the renal vasculitis in children is – | options: A: Increased IgA level B: Low complement level C: ↑ Antineutrophilic cytoplasmic antibody titre D: Increase antinuclear antibody | answer: A </s> |
<s>[INST] context: Carboxylation The only known biological role of vitamin K is as a cofactor for an enzyme carboxylase that catalyzes carboxylation of glutamic acid residues on vitamin K-dependent proteins. The key vitamin K-dependent proteins include: Coagulation proteins: factors II (prothrombin), VII, IX and X Anticoagulation proteins: proteins C, S and Z Bone proteins: osteocalcin and matrix-Gla protein Gas6 is a vitamin K-dependent protein that is found throughout the nervous system, as well in the hea, lungs, stomach, kidneys, and cailage. These proteins have in common the requirement to be post-translationally modified by carboxylation of glutamic acid residues (forming gamma-carboxyglutamic acid) in order to become biologically active. Prothrombin, for example, has 10 glutamic acids in the amino-terminal region of the protein which are carboxylated. Without vitamin K. the carboxylation does not occur and the proteins that are synthesized are biologically inactive. Carboxylation of glutamic acid residues is critical for the calcium-binding function of those proteins. Also Know There are two naturally occurring forms of vitamin K: - phylloquinone synthesized by plants - menaquinones synthesized by intestinal bacteria Synthetic forms of vitamin K are: - menadiotze - menadiol - menadiol acetate [/INST] question: Vitamin K is required for | options: A: Hydroxylation B: Chelation C: Transamination D: Carboxylation | answer: D </s> |
<s>[INST] context: Have you ever heard of Jinjiang Hotel? It is on our busiest street. It's the best place to live in if you travel here. The hotel is only 0.5 kilometer from the biggest supermarket and the subway.
It has three kinds of rooms for different people to use. The first kind is standard room, that is two beds with a bathroom. It offers you the air conditioner, the television and the telephone. Second is the single room, that has only one bed. Though it has only one bed, you can enjoy yourself, for the bed is really comfortable and the environment is really good. The last one we call commercial room. That is served for businessmen. The commercial room has the best quality. It also provides 24-hour hot water. You can have free tea in the afternoon. Imagine how nice as you drink tea as talking about your business with your partners. If you want to eat something, please just call 123, the food will arrive in ten minutes.
One great thing is that it is very safe here because we have a few strong guards working day and night, so I'm sure you will have a great time living here. [/INST] question: If you live in Jinjiang Hotel, you can _ easily. | options: A: go to a movie B: go shopping C: see a doctor D: have fast food | answer: B </s> |
<s>[INST] context: We all know that theme parks are places to have fun and amuse ourselves, but among so many exciting rides there are also some dangers, Make sure you know what the safety standards are for all the attractions at the park. If you do that , you will be safe and have fun.
Drink water. Believe it or not , dehydration-- when your body doesn't have enough water--is the commonest cause of injuries at theme parks. Drinking water while you are at the park is not enough.You must make sure that you drink enough water before your visit.
Use your "common sense". There are lots of people around , so make sure where your friends or family are .Also ,if you are walking and want to stop , make sure nobody is walking behind you. First step aside,then look behind and if you aren't in anybody's way,then stop.It might sound exaggerated ,but crashes between people can cause accidents.
Follow the instructions. The majority of theme parks have instructions for each ride. Some rides only allow people of a certain height. So make sure you are not too tall or too short before boarding any ride. Also, people with certain diseases or conditions are advised not to go on some rides. Do remember : If you are told not to go on a ride, then DON'T.
Do not ride with a bad atomach or if you've just eaten. Rides can make you ill because of their violent changes of direction and your lunch may end up on someone else's head: surely not a very pleasant experience.
Have fun, relax, and be a little brave!
Some rides might look scary but theme parks are very safe places. [/INST] question: What is the leading reason for injuries at theme parks? | options: A: Snow B: Dehydration C: Fire D: Crashes | answer: B </s> |
<s>[INST] context: There are many wetlands in China and some of them have become the world's important wetlands. The Chinese Yellow Sea Wetlands are among them. They are in Yancheng,Jiangsu Province. They are home of many different kinds of birds and animals. The world's largest Milu Deer Nature Reserve is in them. More than 700 milu deer live freely there.
The temperature in the wetlands is usually neither too high nor too low. There is a lot of rain and sunshine,too. They are really good places for wildlife. Offering food and home for some special kinds of animals and birds is not the only reason why we need to protect wetlands.
Wetlands are important because they also prevent flood. But some people want to change the wetlands to make more space for farms and buildings. This means there will be less and less space for wildlife.
Luckily, more and more people are beginning to realize the important of wetlands and wildlife. Every year, on February 2nd many activities are held to tell people more about wetlands around the world. [/INST] question: Usually the weather in the wetlands is _ . | options: A: hot B: mild C: cold D: dry | answer: B </s> |
<s>[INST] context: Pharyngoconjunctival fever is caused most commonly by serotypes 3 and 7, but serotypes 2, 4 and 14
also, have been documented as etiologic agents.
Ocular infections caused by Adenovirus -
i. Epidemic keratoconjunctivitis → Serotypes 8, 19, 37
ii. Follicular conjunctivitis → Serotypes 3,7
iii. Pharyngoconjunctival fever - Serotypes 3, 7
Adeno Virus
Non-enveloped, DNA (ds DNA) Virus
Has characteristic morphology consisting of an icosahedral shell composed of 20 equilateral triangular faces and 12 vertices → space vehicle appearance.
Human adenovirus grows only in tissue culture of human origins, such as human embryonic kidney, HeLa or HEP-2.
The cytopathic effect in tissue culture → cell rounding and aggregation into grape-like clusters.
Adenovirus has been used as a vector for gene therapy.
Adenovirus cause infections of the respiratory tract and eyes and less often of the intestine and urinary tract.
Most frequently affect infants and children
Clinical manifestations
□ Most common manifestation in children is an acute upper respiratory tract infection with prominent rhinitis.
□ Most common manifestation in an adult is ARDS [/INST] question: Pharyngoconjunctival fever is caused by - | options: A: Adenovirus 3 and 7 B: Adenovirus 11, 21 C: Adenovirus 40, 41 D: Adenovirus 8, 19 | answer: A </s> |
<s>[INST] context: Societies all over the world name places in similar ways. Quite often there is no official naming ceremony but places tend to be called names as points of reference by people. Then an organized body steps in and gives the place a name. Frequently it happens that a place has two names: One is named by the people and the other by the government. As in many areas, old habits _ and the place continues to be called by its unofficial name long after the meaning is lost.
Many roads and places in Singapore are named in order that the pioneers will be remembered by future generations. Thus we have names such as Stamford Road and Raffles Place. This is in keeping with traditions in many countries --in both the West and the East.
Another way of naming places is naming them after other places. Perhaps they were named to promote friendships between the two places or it could be that the people who used to live there were originally from the places that the roads were named after. The mystery is clearer when we see some of the roads named in former British bases. If you step into Selector Airbase you will see Piccadilly Circus --obviously named by some homesick Royal Air Force personnel.
Some places were named after the activities that used to go on at those places. Bras Basah Road is an interesting example, "Base Basah" means "wet rice" in Malay . Now why would anyone want to name a road "Wet Rice Road"? The reason is simple. During the pioneering days, wet rice was laid out to dry along this road.
A few roads in Singapore are named by their shapes. There is "Circular Road" for one. Other roads may have part of their names to describe their shapes, like "Paya Lebar Crescent". This road is called a crescent because it begins on the main road, makes a crescent and comes back to join the main road again. [/INST] question: Which of the following places is named after a person? | options: A: Raffles Place B: Selector Airbase C: Piccadilly Circus D: Paya Lebar Crescent | answer: A </s> |
<s>[INST] context: "I never expected that I would be so busy. Why can't there be 25 hours in a day?" complained Liu Ran in Hong Kong as mid-term exams were going on.
The 18-year-old was Shandong Province's top scorer in this year's college entrance examination. After graduating from Tai'an No.1 High School, she chose the Chinese University of Hong Kong , although both Peking University and Tsinghua University promised her a place.
"I want to experience a more international school and social life in Hong Kong. I'm majoring in journalism, so Hong Kong will surely help widen my horizons," Liu said.
It is two months since Liu first set foot on Hong Kong. She missed home a lot at the beginning, because of the food and language problems.
"The canteen offers mostly Western or Guangdong food, but it's convenient to cook for ourselves in our dorm if we like. People speak Cantonese and almost all classes are in English," Liu explained.
Her English and Cantonese are now both improving, but she still needs more time to adapt to the new environment.
"I'm happy that I made the right decision to study here. With a mix of the Eastern and Western cultures, there is so much to discover and learn," she said.
Liu has 18 credit hours of classes every week and 23 non-credit hours every other week. She has signed up for four associations including the Chinese Language Debating Team and the drama club. Essays, book reports and presentations also take plenty of time to prepare. And , of course, there are various parties to attend.
"I wasn't a party animal before, but that may be interesting part of college. I sense myself changing," Liu said. [/INST] question: Liu Ran chose the Chinese University of Hong Kong, because _ . | options: A: she couldn't be admitted to Peking University B: Hong Kong is a good place C: she wants to be far from her homeland D: the Chinese University of Hong Kong can widen her horizons | answer: D </s> |
<s>[INST] context: My friend Jennie gave her bone marrow( )to a 50-year-old woman, a woman she has never met.
At the end of March, the Red Cross called back. Six different blood elements were tested ; Jennie matched five completely and was about a 3/4 match of the six. So she was the best match.
In April, Jennie went for a complete physical exam by one of the doctors who would perform the surgery. The doctor had to make sure that it would be no tread to her. The doctor told her that the surgery would need to have two quarts of bone marrow from her hip bones. Jennie would probably be released the same day the surgery took place and should expect to be painful for a couple of months.
"I didn't think it was that big a deal until I realized I was a match," Jennie said. "There was not a question in my head. It didn't seem like something that was going above and beyond. "
Jennie was left with two very small scars on her lower back from the surgery and was giving medication to help reduce the pain. She still felt a great deal of pressure on her lower back. "Being only 21, I felt like I am not old enough to significantly impact someone's life," Jennie said. " It seems strange to me that I could possibly save this woman's life which was being cut short by cancer. "
Three weeks after the surgery, Jennie received a car from the Red Cross representative who told her the transplant was successful. "I feel good, and I think it will actually work for her. " She said, "So many people say that they'd only donate if it was for a family member or close friend. This woman was someone's family and someone's friend. Obviously no one she knows is a match, and the fact that you'd be able to help a perfect stranger is greater. " [/INST] question: Jennie gave her bone marrow to _ . | options: A: a close friend B: a stranger C: a classmate D: a | answer: B </s> |
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