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<s>[INST] context: Vasoconstriction, vascular proliferation, thrombosis, and inflammation appear to underlie the development of PAH ( Fig. 250-2 ). Abnormalities in multiple molecular pathways and genes that regulate the pulmonary vascular endothelial and smooth muscle cells have been identified. These abnormalities include decreased expression of the voltage-regulated potassium channel, mutationsin the BONE MORPHOGENETIC PROTEIN -2 RECEPTOR , increased tissue factor expression, overactivation of the serotonin transpoer, trans cription factor activation of hypoxia-inducible factor-1 alpha, and activation of nuclear factor of activated T cells. As a result, there appears to be loss of apoptosis of the smooth muscle cells that allows their proliferation and the emergence of apoptosisresistant endothelial cells that can obliterate the vascular lumen. In addition, thrombin deposition in the pulmonary vasculature from a procoagulant state that develops as an independent abnormality or as a result of endothelial dysfunction may amplify the vascular proliferation. ref:Harrison&;s principles of internal medicine,ed 18,pg no 2077 [/INST] question: In primary pulmonary hypeension basic abnormality in genelies in- | options: A: Bonemorphogenetic protein receptor 11 B: Endothelin C: Homeobox gene D: PAX-II | answer: A </s> |
<s>[INST] context: Bitewing (also called interproximal) images include the crowns of the maxillary and mandibular teeth and the alveolar crest on the same receptor.
Bitewing receptors are particularly valuable for detecting interproximal caries in the early stages of development before it becomes clinically apparent. Because of the horizontal angle of the X-ray beam, these radiographs also may reveal secondary caries below restorations that may escape recognition in the periapical views.
Bitewing projections are also useful for evaluating the periodontal condition. They provide a good perspective of the alveolar bone crest, and changes in bone height can be assessed accurately through comparison with the adjacent teeth. In addition, because of the angle of projection directly through the interproximal spaces, the bitewing receptor is especially effective and useful for detecting calculus deposits in interproximal areas. (Because of its relatively low radiodensity, calculus is better visualized on images made with reduced exposure).
Oral radiology White and Pharaoh; 7th ed. Page no 114 [/INST] question: Bitewing radiographs are best suited to monitor: | options: A: Unerupted teeth B: Crestal bone levels C: Crown preparations D: Endodontic procedures | answer: B </s> |
<s>[INST] context: First lady Michelle Obama has some advice for some Tennessee High School graduates: Strike your own path in college and life and work to overcome inevitable difficulties with determination and courage.
The first lady told the 170 graduates that she spent too much of her own time in college focusing on academic achievements. While her success in college and law school led to a high-profile job, she said, she ended up leaving to focus on public service.
"My message to all of you today is this: Do not waste a minute living someone else's dream,"she said. "It takes a lot of real work to discover what brings you joy... and you won't find what you love simply by checking boxes or padding your GPA ."
She said the school reminded her of her own high school experience in Chicago. "My No. 1 goal was to go to a high school that would push me and challenge me," she said. "I wanted to go somewhere that would celebrate achievement. A place where academic success wouldn't make me a target of teasing or bullying, but instead would be a badge of honour." But Mrs. Obama said pitifully that not all students have the same opportunities. "Unfortunately, schools like this don't exist for every kid," she said. "You are lucky."
The first lady told graduates that failure may be a part of their college lives and careers, and that how they respond to any difficulties will define them. "That's when you find out what you're really made of in those hard times," she said. "But you only do that if you're willing to put yourself a position where you might fall."
Overcoming difficulties has been the hallmark of many great people, she said. "There's this guy Barack Obama... he lost his first race for Congress, and now he gets to call himself my husband." The first lady joked: "I could take up a whole afternoon talking about his failures." [/INST] question: Michelle went to Tennessee High School to _ . | options: A: visit her old school B: help the votes for Obama C: welcome new students D: give some advice for the graduates | answer: D </s> |
<s>[INST] context: Tom goes everywhere with Catherine Green, a 54-year-old secretary. He moves around her office at work and goes shopping with her. "Most people don't seem to mind Tom," says Catherine, who thinks he is wonderful. "He's my fourth child," she says. She may think of him and treat him that way as her son. He moves around buying his food, paying his health bills and his taxes, but in fact Tom is a dog.
Catherine and Tom live in Sweden, a country where everyone is expected to lead an orderly life according to rules laid down by the government, which also provides a high level of care for its people. This level of care costs money.
People in Sweden pay taxes on everything, so aren't surprised to find that owning a dog means more taxes. Some people are paying as much as 500 Swedish kronor in taxes a year for the right to keep their dog, which is spent by the government on dog hospitals and sometimes medical treatment for a dog that falls ill. However, most such treatment is expensive, so owners often decide to offer health and even life _ for their dog.
In Sweden dog owners must pay for any damage their dog does. A Swedish Kennel Club official explains what this means: if your dog runs out on the road and gets hit by a passing car, you, as the owner, have to pay for any damage done to the car, even if your dog has been killed in the accident. [/INST] question: Catherine pays taxes for Tom because _ . | options: A: Tom follows her everywhere B: Tom is her child C: Tom is her dog D: Tom often falls ill | answer: C </s> |
<s>[INST] context: People have talked about whether aliens are real or not for thousands of years.Some ancient drawings over 50,000 years ago are thought to be the first pictures of spacecrafts.Alien spacecrafts are often called flying saucers .The first person to use this name was an Amerlean,Kenneth Arnold.On 24th June,1947,he was flying a small plane in Washington State in the USA when he saw something strange."I was looking out of the window,"Arnold said,"when I saw nine saucer-like things in front of me."
Two other Americans,Charles Hickson and Calvin Parker,said that aliens took them into a flying saucer! They were fishing on the Mississippi River in the USA on the night of 11th October,l973.It was a dark night.The two men were sitting in their fishing boat when they saw a bright light.It was hanging in the air over the water and it looked like a flying saucer and brought Hickson and Parker into their spacecraft.In the spacecraft the aliens looked at the two men very carefully and then took them back to their boat."The aliens were in a pale colour and had very small eyes." Hiekson said."But they didn't hurt us."
In l983,Pioneer 10,an American spacecraft,went into space.On the outside of the spacecraft are 13 pictures of men and women,and a map of space.If aliens find Pioneer 10,they will know how to get to the Earth! [/INST] question: When did Kenneth Arnold see something strange as he was flying? | options: A: 11th June,1947 B: 24th June,1947 C: 11th October,1973 D: 11th October,1983 | answer: B </s> |
<s>[INST] context: If you have ever been sad because of failure,please remember,for often,achieving what you set out to do is not the most important thing.
A boy decided to dig a deep hole behind his house.As he was working,a couple of older boys stopped by to watch."What are you doing?" asked one of the visitors."I want to dig a hole all the way through the earth!" the boy answered excitedly.The older boys began to laugh,telling him that digging a hole all the way through the earth was impossible.After a while,the boy picked up a jar.He showed it to the visitors.It was full of spiders,worms and other insects.Then he said quietly and confidently,"Even if I can't dig all the way through the earth,look what I found along the way!"
The boy's goal was far too difficult,but it did cause him to dig.And that is what a goal is for--to cause us to move in the direction we have chosen,in other words,to cause us to dig!
Not every goal will be fully achieved.Not every job will end successfully.Not every dream will come true.Not every love will last.But when you fall short of your aim,maybe you can say,"Yes,but look what I found along the way!Look at the wonderful things which have come into my life because I tried to do something!"
It is in the digging that life is lived.And I believe it is joy in the journey that really matters. [/INST] question: The older boys laughed at the boy because he was thought to be _ . | options: A: brave B: impolite C: foolish D: warmhearted | answer: C </s> |
<s>[INST] context: In elective surgery of abdominal aortic aneurysm, the operative mortality rate approximates 1 to 2% whereas after acute rupture the mortality rate of emergency operation generally approximates 45- 50%.
Abdominal Aortic Aneurysms
Abdominal aortic aneurysm (AAA) is the most common true arterial aneurysm.
An aortic aneurysm is defined as a focal dilation of the aorta with a diameter of at least 1.5 times that of the expected normal diameter of that given aortic segment; in the AA, enlargement of the aortic diameter of more than 3 cm is usually considered aneurysmal.
A most common site is infrarenal.
More common in males than females.
Incidence increases with age.
At least 90% of all abdominal aortic aneurysms >4.0 cm are related to atherosclerotic disease.
Prognosis is related to both the size of an aneurysm and the severity of coexisting coronary artery and cerebrovascular disease.
The risk of rupture is directly related to the size of an aneurysm.
An abdominal aortic aneurysm is usually asymptomatic. They are usually detected incidentally on routine clinical examinations or investigation performed for some other reasons.
As abdominal aortic aneurysms expand, however, they may become painful. Aneurysmal pain is usually a harbinger of rupture and represents a medical emergency. More often, acute rupture occurs without any prior warning, and this complication is always life-threatening.
Contrast-enhanced CT is an investigation of choice. MRI is as sensitive and specific as CECT and is used if the use of contrast is precluded. Ultrasound is the screening study of choice and is useful for serial documentation of aneurysm size
Operative repair of an aneurysm with the insertion of a prosthetic graft or endovascular placement of an aortic stent graft is indicated for:
abdominal aortic aneurysms of any size that are expanding rapidly or are associated with symptoms.
for asymptomatic aneurysms, abdominal aortic aneurysm repair is indicated if the diameter is >5.5 cm.
The decision to perform an open surgical operation or endovascular repair is based in part on the vascular anatomy and comorbid conditions.
Endovascular repair of abdominal aortic aneurysms has a lower short-term morbidity rate but a comparable long-term mortality rate with open surgical reconstruction. (Harrison 18/e)
In Elective surgery of abdominal aortic aneurysm the operative mortality, rate approximates 1 to 2% whereas after acute rupture the mortality rate of emergency operation generally exceeds 50%. [/INST] question: The mortality rate of emergency operation for abdominal aortic aneurysm is: | options: A: 1% B: 5% C: 20% D: 50% | answer: D </s> |
<s>[INST] context: When you get up in the morning, do you find it hard to choose what clothes to wear? If so, you probably need help to make the bigger choices in your life, like what to do when you're older. Brave New Girls, by American author Jean Gade-berg, will help you make such choices. It says you must be a brave new girl. A brave new girl is one who is confident, healthy and happy. A brave new girl can realize her dreams. To be brave, you need to make a decision for yourself. Other people may tell you what to do, but you should not listen to them. You must only do what you want. If you always wear clothes like your favourite TV star, you must stop doing so. Instead, become your own star and wear the clothes you want. You have to like your body, it says. If you don't, you will not take good care of it, and it won't stay healthy. The book also says that girls must start becoming more confident. If you are confident, you'll succeed in life. A good way to become confident is to realize that you are as clever as boys. In fact you are. Just look at their grades! Only then can you realize your dreams and become who you want to be. [/INST] question: Brave New Girls is a _ . | options: A: film B: story C: book D: newspaper | answer: C </s> |
<s>[INST] context: Although there are no state controlled survival courses in Britain or the United States,there are various independent organizations offering similar activities.Students can participate(take part)in outdoor training courses through university clubs and societies.Anyone can register with such groups,which then organize courses,training and trips for all members.
One of the most popular outdoor training programmes in both the US and Britain is Outward Bound .It was founded in 1941 in Wales and attracts hundreds of thousands of adventurous types every year. The courses are intended to broaden minds through experiences that build confidence, self-esteem and character.As well as specialist courses such as canoeing,leadership skills and sailing,participants can take part in week long adventure training camps which include a host of sports and survival training education skills.
Michael Williams,an American student,took part in an Outward Bound course last year.He said:"We learned lots of first aid skills,lots of natural history ,lots of environmental facts, and participated in a wildlife preservation programme.Beyond that,my favorite skills learned were sailing and rock climbing."Courses can last up to 40 days and are open to anyone over the age of 14.Students must be in general good health,but do not need to be experienced in outdoor-sports.There is no selection process;everyone is welcome,although new participants are advised to pick a course matching their physical capacity.Most of the British courses take place in the Brecon Beacons in Wales.Another similar organization is the UK Survival School,which includes courses on learning to 1ive with the environment, sailing and winter survival.On a basic survival weekend students will learn how to get water and food, how to make fire and cook with it,to find and build a shelter,control survival life support,how to cross rivers.Send off a distress signal,and to use compasses by day and night.
According to the leaders,such adventures are "an awakening, an exploration into the unknown."Outward Bound believes that participants will "use mind and body traveling some of the Earth's roughest wilderness areas." [/INST] question: In Britain and the United States,survival courses are popular with _ . | options: A: old people B: young people C: dangerous people D: weak people | answer: B </s> |
<s>[INST] context: Idiopathic thrombocytopenic purpura
There are two clinical subtypes of primary I.T.P, acute and chronic both are autoimmune disorders in which platelet destruction results from the formation of antiplatelet antibodies.
Pathogenesis
Chronic ITP is caused by the formation of autoantibodies against platelet membrane glycoproteins most often IIb-IIIa or Ib-IX.
In the overwhelming majority of cases, the antiplatelet antibodies are of the IgG class.
The mechanism of platelet destruction is similar to that seen in autoimmune hemolytic anemias. Opsonized platelets are rendered susceptible to phagocytosis by the cells of the mononuclear phagocyte system.
The spleen is the major site of the destruction of platelets.
Pathology
The principal morphologic lesions of thrombocytopenic purpura are found in the spleen and bone marrow but they are not diagnostic.
The point to stress is that despite the increased destruction of platelets in the spleen, the spleen size remains normal.
On histological examination, there is congestion of the sinusoids and hyperactivity and enlargement of the splenic follicles manifested by the formation of prominent germinal centres. Sometimes scattered megakaryocytes are found within the sinuses and sinusoidal walls. This represents a very mild form of extramedullary hematopoiesis. These splenic findings are not sufficiently distinctive to be considered diagnostic.
Bone Marrow
Bone marrow reveals a modestly increased number of megakaryocytes.
These findings are not specific for autoimmune thrombocytopenic purpura but merely reflect accelerated thrombopoiesis, being found in most forms of thrombocytopenia resulting from increased platelet destruction.
The importance of bone marrow examination is to rule out thrombocytopenias resulting from bone marrow failure.
A decrease in the number of megakaryocytes goes against the diagnosis of I.T.P. [/INST] question: Cause of ITP is - | options: A: Vasculitis B: Antibody to vascular epithelium C: Antibody to platelets D: Antibody to clotting factors | answer: C </s> |
<s>[INST] context: Orotracheal intubation Patients with severe maxillofacial trauma and with low Sp02 even on oxygen suggests severe airway compromise or obstruction. In these cases emergency airway management is essential. The patient require immediate oxygen. - These patients needs to be intubated immediately. - But an impoant point to note is that severe maxillofacial trauma makes intubation very difficult. -Some believe that nasotracheal intubation is contraindicated in patients with severe maxillofacial injury because nasotracheal intubation in these patients can result in nasocranial intubation or severe nasal hemorrhage. - Nasotracheal intubation is absolutely contraindicated in patients with midfacial injury and C.S.F. rhinorrhoea. Orotracheal intubation in patients with severe maxillofacial injury In patients with severe maxillofacial injuries orotracheal intubation is also difficult. Presence of blood clots, .fractures make the passage of the tube quite difficult. Moreover when the surgeons perform operation for mandibular or maxillary fractures they wires both these together. If surgery is required with severe maxillofacial injury surgeons usually prefer nasotracheal intubation or tracheostomy. Tracheostomy in patient with severe maxillofacial injury : ? Tracheostomy does not have much role in "emergency airways management". - Tracheostomy is a time taking procedure compared to intubation. - If the airways of the patient is severely compromised and he requires immediate oxygenation, tracheostomy has no role. - Immediate oxygenation can only be delivered by rapid intubation. In case, intubation is impossible, cricothyroidotomy is an alternative. -In emergency management of the airway, cricothyroidotomy is done if intubation is not possible. Tracheostomy is only done when immediate oxygen requirements are taken care of and a surgical procedure is planned. In the question the Sp02 of the patient is 80% when on oxygen. He requires immediate emergency management of the airway which can be achieved through intubation, If intubation is impossible, cricothyroidotomy is an alternative. The better option of intubation in this patient is orotracheal intubation. The ideal management in this patient is cricothyroidotomy. Since that is not mentioned in the question intubation in the next best option. "Orotracheal intubation would be preferred over nasotracheal intubation in these cases" [/INST] question: A 40 year old man who met with a motor vehicle catastrophe came to the casualty hospital in an hour with severe maxillofacial trauma. His Pulse rate was 120/min, BP was 100/70 mm Hg, Sp02 -80% with oxygen. What would be the immediate management | options: A: Nasotracheal intubation B: Orotracheal intubation C: Intravenous fluid D: Tracheostomy | answer: B </s> |
<s>[INST] context: (G1 - S phase) (60-195- Basic pathology 8th)* The S phase is the point of no return in the cell cycle and before the cell makes the final commitment to replicate - the G1/S checkpoint checks for damage.* This causes delay at G1/S checkpointThis delay in cell cycle progression provides the time neededfor DNA repair and if the damage is not reparable, apoptoticpathways are activated to kill the cell.G2 M checkpoint* This check point in used for the repair of the DNA which is damaged after its replication* The G2M checkpoint monitors the completion of DNA replication and checks whether the cell can safely initiates mitosis and separate sister chromatids(i) This checkpoint is particularly important in cells exposed to ionizing radiations(ii) Defects in this check points give rise to chromosomal abnormalityAlso known Effector for G1S checkpoint - Mostly mediated through P53 which induces the cell cycle inhibitor P21 Effector for G2M checkpoint - Involves both P53 and independent mechanismCyclinKinaseFunctionsDCD4.CDK6Progression past restriction at G1S boundaryEl-ACDK-2Initiation of DNA synthesis in early S phaseBCDK-1Transition from G2 to M [/INST] question: The tumor suppressor gene P53 induces cell arrest at | options: A: G2- M phase B: S- G2 phase C: G1-S phase D: G0- phase | answer: C </s> |
<s>[INST] context: At a primary school in a small town in the east of South Carolina, second-grade teachers Garneau and Lynne are convinced that separating elementary-age boys and girls produces immediate academic improvement in both genders .
David Chadwell, South Carolina's expert of single gender education says, "Boys and girls learn, hear and respond to their surroundings differently.We can teach boys and girls based on what we now know."
Male and female eyes are not organized in the same way, he explains.The organization of the male eye makes it sensitive to motion and direction."Boys understand the world as objects moving through space," he says.
The male eye is also drawn to cooler colors like silver and black.It's no accident that boys tend to create pictures of moving objects instead of drawing the happy colorful family, like girls do in their class.
The female eye, on the other hand, is drawn to warmer colors like red, yellow and orange.To attract girls, Chadwell says, the teacher doesn't need to move as much as in boy's class.Using descriptive phrases and lots of colors in presentations or on the blackboard gets their attention.
Boys and girls also hear differently."When someone speaks in a loud tone, girls understand it as yelling," Chadwell says."They think you're mad and can shut down." Girls are more sensitive to sounds.He advises girls' teachers to watch the tone of their voices.Boys' teachers should sound more forceful, even excited.
A boy's nervous system causes him to be more cautious when he is standing, moving, and the room temperature is around 69 degrees Fahrenheit.Stress in boys, he says, tends to increase blood flow to their brains, a process that helps them stay focused.Girls are more focused when seated in a warmer room around 75 degrees Fahrenheit.Girls also respond to stress differently.When exposed to threat and conflict, blood goes to their guts , leaving them feeling nervous or anxious.
These differences can be applied in the classroom, Chadwell adds."Single gender programs are about making the best use of the learning." [/INST] question: What is David Chadwell's attitude toward separating elementary-age boys and girls while learning? | options: A: Supportive B: Worried C: Concerned D: Uninterested | answer: A </s> |
<s>[INST] context: Once upon a time,a hippo lived in a river next to a big tree.
One day,a bird came and nested in the tree.The songs of the bird filled the hippo with so much envy that he couldn't think of anything else.Every day he would think why he wasn't born to be a bird even though the bird told him many times he was so lucky to be so big and such a good swimmer.
Finally,the hippo made up his mind that he would come out of the river,climb the tree and start singing.However,when he tried to climb the tree,it was very clear that the hippo didn't have wings,nor claws to climb with.
Realizing that he would never climb up the tree,he angrily hit the tree until it came crashing to the ground.Then he stepped onto the leaves of the fallen tree,and began singing.
Unfortunately,hippos can't sing,either.All that came from his mouth were terrible noises,and when the other animals heard this,they all came around to make fun of the hippo.
He was so ashamed by this.He also felt bad about having knocked the tree over.He used all his strength to raise the tree back up again,and look after it until it completely recovered. . [/INST] question: The hippo envied the bird because _ . | options: A: he could fly high B: he could build a nest C: he could sing well D: he could live in the tree | answer: C </s> |
<s>[INST] context: A ten-year-old boy from Howell, Michigan America is being hailed (...) a hero due to his persistence that led to saving the life of an elderly neighbor. The chain of events unfolded late in the evening on Sunday, January 26th, 2014 when Danny Dipietro was being driven home from hockey practice by his dad.
That's when the young boy noticed an open garage and a figure that he believed was a dog outside an apartment near his house. Given the extremely cold weather, the young boy got a feeling that something was not right. But instead of dismissing it like most kids at his age would have, he insisted that his mother, Dawn, go to examine what was going on. Dawn tried to convince Danny that no one would leave a dog out in such cold weather, but he refused to take no for an answer.
Dawn finally gave in and decided to take a walk to the area with the family dog and see if there was any truth to Danny's premonition . Sure enough, as she got closer to the apartment she noticed a garage that was wide open and a bent figure, waving madly. Upon getting there, she realized that it was not a dog that the young boy had seen, but Kathleen St. Onge, one of her neighbors. The 80-year-old had slipped on some ice in her garage and had been lying there for two hours, unable to get up.
Dawn rushed home to get her husband for help and called 911. The two then returned with some blankets to cover Ms. St. Onge, while they waited for the ambulance to arrive. Though still in hospital, the elderly woman is recovering well and grateful to Danny for his premonition. [/INST] question: Why didn't Dawn want to have a look at first? | options: A: Because it was too cold outside B: Because she thought Danny lied C: Because she didn't think people would leave a dog out on such a cold day D: Because she was busy with her work | answer: C </s> |
<s>[INST] context: Need for closure is a psychological term that describes a person's desire for a firm answer to a question. Our need for closure is our natural preference for definite answers over confusion and uncertainty. Every person has their own baseline level of need for closure. It likely evolved via natural selection.
What I find really fascinating is how our need for closure is affected by the situation we're in. Our need for closure rises when we have to act rather than just observe, and it matters much more when we're rushed, or bored, or tired. Any stress can make our discomfort with uncertainty increase, and a high need for closure negatively influences some of our most important decisions: who we decide to trust, whether we admit we're wrong and even how creative we are.
In hiring, for instance, a high need for closure leads people to put far too much weight on their first impression. It's called the Urgency Effect. In one experiment, psychologists tried to lower people's need for closure by telling them, right before participants are about to make various judgments of a job candidate, that they'll be responsible in some way for them, or that their judgments have serious consequences.
In making any big decision, it's not enough just to know that we should take our time. We all know that important decisions shouldn't be rushed. The problem is that we don't keep that advice in mind when it matters. So, one of the best solutions is to formalize the reminders. Before making important decisions, write down not just advantages and disadvantages but what the consequences could be. Also, think about how much pressure you're under. If your need for closure is particularly high that day, it's even more important to think twice. [/INST] question: How does "need for closure" probably come into being? | options: A: By accident B: By nature C: By acquiring D: By imitating | answer: B </s> |
<s>[INST] context: Many teenagers feel that the most important people in their lives are their friends.They believe that their family members, especially their parents.Don't know them as well as their friends do.In large families.it is often for brothers and sisters to fight with each other and then they can only go to their friends for advice.
It is very important for teenagers to have one good friend or many friends.Even when they are not with their friends, they usually spend a lot of time talking among themselves on the phone.This communication is very important in children's growing up, because friends can discuss something difficult to say to their family members.
However, parents often try to choose their children's friends for them.Some parents may even stop their children from meeting their good friends. The question of "choice" is an interesting one.Have you ever thought of the following questions?
Who choose your friends?
Do you choose your friends or your friends choose you?
Have you got good friend your parents don't like? [/INST] question: Many teenagers think their _ know them better than their parents do. | options: A: friends B: teachers C: brothers and sisters D: classmates | answer: A </s> |
<s>[INST] context: In Kenya, educational and career opportunities are almost non-existent for people born with physical challenges. They face many forms of discrimination -- including beliefs that their condition was caused by a curse. But one father whose son Brain was born deaf, mute and blind aims to change all that. Joseph Shiroko started a school four years ago that teaches students who can not hear, speak and who have very low or no vision a wide range of skills to support themselves.
The baby clothes the students knit are well known in the local community. And the school has developed a reputation for its dried smoked meat products.
Brain Resource Center, a boarding school, teaches deaf and blind young Kenyans from across the country a variety of skills they can use to earn a living.
"We have a number of philosophies that inform what we are doing: accepting these people; loving them; giving them opportunities." said founder Joseph Shiroko.
Teachers, most of whom are graduates from the school or are themselves physically challenged, work with students.
Mary Kerubo, 22, has a passion for knitting sweaters, which she plans to continue in her village.
"I feel comfortable here because Sween -- my teacher understands me," said Kerubo. "Even if I do not see well, she always repeats her lessons again and again so that I may understand how to make sweaters. I know I will make it."
Kerubo's teacher, Sween Lyaka, was among the first graduates of Brain Resource Center four years ago. She says her students have a lot of unrecognized potential.
Sween says in the future, she plans to purchase four sewing machines that she will use to teach students and produce and sell sweaters in her home village.
The center also works with students' families to set up projects that will continue after the students graduate.
Founder Joseph Shiroko's son, Brain, was the inspiration behind Brain Resource Center. The senior Shiroko says he began the school initially as a project to teach Brain bakery skills. The family later expanded Brain's training and brought in other young people with similar physical conditions. [/INST] question: The founder Joseph Shiroko treats children with physical problems except _ . | options: A: loving them B: accepting them C: ignoring them D: giving them opportunities | answer: C </s> |
<s>[INST] context: Refer Robbins page no p 957 Barrett esophagus is a complication of chronic GERD that is characterized by intestinal metaplasia within the esophageal squamous mucosa. The incidence of Barrett esophagus is rising, and it is estimated to occur in as many as 10% of individuals with symptomatic GERD. Barrett esophagus is most common in white males and typically presents between 40 and 60 years of age. The greatest concern in Barrett esophagus is that it confers an increased risk of esoph- ageal adenocarcinoma. Genomic sequencing of biopsies involved by Barrett esophagus has revealed the presence of mutations that are shared with esophageal adenocarci- noma, in keeping with the idea that Barrett esophagus is a precursor lesion to cancer. Potentially oncogenic mutations are more numerous when biopsies demonstrate dysplasia, which is detected in 0.2% to 2% of persons with Barrett esophagus each year. The presence of dysplasia, a prein- vasive change, is associated with prolonged symptoms, longer segment length, increased patient age, and Caucasian race. Although the vast majority of esophageal adenocar- cinomas are associated with Barrett esophagus, it is impor- tant to remember that most individuals with Barrett esophagus do not develop esophageal tumors. [/INST] question: Barrett oesophagus can result from | options: A: H. Pylori infection B: H. Simplex infection C: Gastroesophagal reflux D: Varices | answer: C </s> |
<s>[INST] context: Everyone should get enough sleep. If a student doesn't sleep well at night, he won't study well and he can't listen to the teacher carefully in class. For a driver, it is easier for him to have an accident if he is tired. Good sleep is also important for your health. Without good sleep, a person may become ill.
It is hard for some people to sleep well. A lot of things can help you get a good night's sleep. First, doing some exercise will help you sleep. Walking, running and bike riding are good ways. Other good ways are playing ball games, such as basketball, soccer or tennis. However, you must not do these just before bedtime.
Second, before you go to bed, you shouldn't drink coffee or any soft drinks. It is also not a good idea to eat sweets. But drinking a cup of warm milk may help you to sleep.
Third, you can take a warm bath or listen to quiet music before you go to bed. Many people find that they are helpful to sleep.
Follow the advice above and have a good sleep every day. Then you can wake up happily in the morning and _ your health. [/INST] question: Just before bedtime, _ will NOT help you to sleep well. | options: A: listening to quiet music B: having a warm bath C: drinking some warm milk D: playing football | answer: D </s> |
<s>[INST] context: Paraganglioma are clusters of neuroendocrine cells associated with the sympathetic and parasympathetic nervous system.
Paraganglioma is the tumor of neuroendocrine cells of these paraganglia that occurs at various body sites including head, neck, thorax and abdomen.
Most common location of paragangliomas is adrenal medulla, where they are referred to as pheochromocytomas.
Other locations are
Paravertebral ganglion (organs of zuckerkandl and rarely bladder)
Paraganglia related to the great vessels of head and neck, so called aorticopulmonary chain, including carotid bodies (most common); ganglion nodosum of vagus nerve; and clusters located about the oral cavity, nose nasopharynx, larynx, and orbit.
Microscopic features of Paraganglioma are:
Composed of nests (zellballen) of round to oval chief cells (neuroectodermal origin) that are surrounded by delicate vascular septa.
Chief cells stain strongly for neuroendocrine markers such as chromogronin, synaptophysin, neuron specific enolase, CD56 and CD57.
There is a supporting stroma of spindle-shaped cells (sustentacular cells), that are positive for S-100 protein.
Neuroendocrine granules [/INST] question: Paraganglioma seen in -a) Carotid body tumorb) Thoraxc) Para-vertebral locationd) Para-aortic lymph nodes | options: A: ab B: bc C: acd D: abc | answer: D </s> |
<s>[INST] context: It was once thought that only time could mend a broken heart, but now scientists think taking a couple of aspirin might be the best way to get over a break-up.
Previous studies have shown that people experience feelings of romantic rejection in the same way that they experience physical pain. And Psychology Professor Water Michel, of Columbia University, also believes that the psychological pain of ending a relationship is similar to physical pain, and should be treated like any other injury. "When we speak about rejection experiences in terms of physical pain, it is not just a metaphor - the broken heart and emotional pain really do hurt in a physical way," he said. "When you look at a picture of the one who broke your heart, you experience a pain in a similar area of the brain which is activated when you burn your arm. "
Research shows that people who are given a simple painkiller, like aspirin, are able to handle feelings of rejection better than _ given a placebo .
'Take two aspirins and call me next morning' would be a cold-hearted response to a friend's late-night report of fresh heartbreak, but it has a solid basis in the research. [/INST] question: The aspirin is a kind of _ . | options: A: wine B: fruit C: dessert D: medicine | answer: D </s> |
<s>[INST] context: Two thirds of the singles looking for love in Britain turned to the Internet last year, according to figures made in public yesterday. Special sites offer introductions to smokers, to Roman Catholics, tall people, beautiful people, frequent flyers and vegans . Technology has brought about a great change in the dating game.
A survey by Parship, a British branch of Europe's largest dating service with more than 1.5 million members, says that 65 percent of the 5.4 million Britons looking for a relationship used online dating services last year.
A spokeswoman for Relate, the relationship advisor, confirmed that a figure of two third feel it all right. "Doing it online allows people quite a lot of privacy, because they can do a bit of quiet research and look around from the comfort of their own home. You don't have to meet a middleman or go to an actual dating agency office, which takes a lot of courage," she said.
There are more than 100 independent online dating agencies in Britain. Parship says that 50 percent of single people believe they will meet a suitable partner through the Internet, up from 35 percent six months ago.
Mary Balfour, the founder, says that the Internet has changed the dating industry completely. "It's like a return to old-fashioned love letters," she said. "You don't base your initial judgment on how someone looks or what his or her figure is like. You e-mail or talk before you actually see each other. Everybody you know who is single these days has at least had a good look at a dating website, introduction agency or personal ad. They have to, because all the old matchmaking institutions have gone. People work harder, settle down later and live more isolated lives. They're much more likely to end the day with a DVD and a can of beer than by going to a village dance." [/INST] question: Singles in Britain can look for love online mainly because of _ . | options: A: Parship B: the help of go-betweens C: technology D: the revolution of dating game | answer: C </s> |
<s>[INST] context: Surprised,
Usually, the mycobacterium is associated with respiratory tract infection.
In HIV infections mycobacterium is an important cause of diarrhoeas.
The incidence of the extrapulmonary disease is increased in patients with HIV.
Work up in an HIV patient with diarrhoea.
The initial evaluation of a patient with HIV infection and diarrhoea includes:-
A set of stool examination including culture, examination for ova and parasites. and
Examination for Clostridium difficile toxin.
Approximately 50% of the time this workup will demonstrate infection with pathogenic bacteria, mycobacteria or protozoa.
AFB +ve organism suggests the presence of Mycobacterium.
We have two options to choose from either mycobacterium. T.B. or mycobacterium avium intracellulare.
Both mycobacterium T.B. and M.A.C. can cause diarrhoea in patients with HIV and obviously, both of them are acid-fast, So, which one to choose from.
I am in favour of Mycobacterium avium intracellular.
MAC infections are more likely to cause diarrhoea.
The presumed portals of entry in MAC are respiratory and gastrointestinal tract.
While discussing HIV patients with diarrhoea. Harrison Says -"Abdominal pain and diarrhoea may be seen with MAC infection."
Thus it seems MAC infection is more likely to cause diarrhoea.
But still, I am not sure of the answer.
The incidence of Mycobacterium T.B. is more than the incidence of MAC in HIV, so mycobacterium T.B. should account for the greater number of diarrhoeal cases in H.I.V. [/INST] question: A patient with HIV has diarrhoea with AF +ve organism in stool. The most likely organism is | options: A: Mycobacterium avium intracellulare B: Mycobacterium tuberculosis C: Mycobacterium leprae D: Mycoplasmas | answer: A </s> |
<s>[INST] context: Too many people want others to be their friends, but they don't give friendship back. That is why some friendships don't last very long. To have a friend, you must learn to treat your friend the way you want your friend to treat you. Learning to be a good friend means learning three rules: be honest; be generous;be understanding.
Honesty means being honest. It is where a good friendship starts. Friends must be able to trust one another. If you don't tell the truth, people usually find out. If a friend finds out that you haven't been honest, you may lose your friend's trust. Good friends always count on one another to speak and act honestly.
Generosity means sharing and sharing makes a friendship grow. You don't have to give your friend your lunch money or your clothes, or enjoy your hobbies and interests together. Naturally you will want to share your ideas and feelings. These can be very valuable to a friend. They tell your friend what is important to you. By sharing them, you help your friend know you better.
Sooner or later everyone needs understanding and help with a problem. Something may go wrong at school. Talking about the problem can make it easier to solve . Turning to a friend can be a first step in solving the problem. So to be a friend, you must listen and understand. You must try to put yourself in your friend's place, so you can understand the problem better.
No two friendships are ever exactly alike . But all true friendships have three things in common . If you plan to keep your friendships, you must practice honesty,Generosity and understanding. [/INST] question: Some friendships don't last very long because _ . | options: A: there are too many people who want to make friends B: they don't know friendship is something serious C: those who give others friendships receive friendships from others D: they don't return friendship to each other | answer: D </s> |
<s>[INST] context: Lao Yang was born in a small town. He liked reading when he studied at school. He thought the writers were respected and could get a lot of money. He wrote a lot of stories and posted them to the editorial departments but didn't receive any answers.
Now he works in a factory. He's busy at work. When he's free, he always reads something. He always remembers he hoped to be a writer when he was young. One day, Xiao Ping, his ten-year-old daughter, came back. She looked worried and didn't eat anything. She said Miss GAO, her Chinese teacher, told them to write a solicit article "My Father" that evening. But she did not know what to write.
"That's easy," said Lao Yang. "Let me help you."
Then he sat down to write the solicit article at once. He easily finished it on time. He was sure Miss GAO would like it. But one afternoon he asked his daughter if the article had been chosen to post to the editorial department.
"My teacher said your article digressed from the subject," said the girl.
"I don't think so," Lao Yang shouted angrily. "I described just my father!" [/INST] question: Lao Yang wrote a lot of stories because _ . | options: A: he likes reading B: he learned much at school C: he wanted to be a writer D: he wanted to help others | answer: C </s> |
<s>[INST] context: Everybody can suffer from stress. No matter what your age is, you can feel stressed out by things that are happening in your life.
Teenagers, however, have many more opportunities to get stressed than people in any other age group. Being a teenager is hard. You are not a child any more, but you are not an adult, even though you have to deal with some very grown-up problems and decisions.
Families can be one of the biggest causes of stress, such as problems with parents arguing at home or problems with brothers and sisters. Teenagers also have a lot of stress from school, either from their teachers or from their friends. Some teenagers also feel stressed about choosing their education after high school. Getting a place at university can be very difficult and some cannot afford to go to university. The stress about getting a job when finishing school is hard for some teenagers. There are so many young people finishing school and not enough jobs for them.
Sadly, there is nothing we can do to remove these causes of stress from the 1ives of teenagers, but you can learn the best way to deal with it. Talking to people is one of the best ways to deal with stress. It may sound simple, but it is true. A problem shared is a problem halved. [/INST] question: Why is being a teenager often difficult? | options: A: Because even though you are not an adult, you must deal with adult problems B: Because even though you are an adult, you must deal with children's problems C: Because even though you are a teenager, you must do a lot of homework D: Because adults often make them feel stressed | answer: A </s> |
<s>[INST] context: C What historical site impresses you most? I've always been fascinated by the pyramids in Egypt.A few years ago I braved a long queue and climbed through a narrow passage to reach the main chamber deep inside one of them.Like millions of other tourists, I marveled at stone-walled rooms full of the magic of this ancient civilization.
But popularity might be the destruction of such archaeological treasures.Take Tutankhamun's tomb in the Valley of the Kings for example.It lay untouched for more than 3,000 years until the British archaeologist Howard Carter uncovered it in 1922.Now more than 1,000 people a day walk through it.
But as more and more people visit, the temperature and humidity inside the tomb change.As a result, the beautifully decorated plaster is coming away from the rock.
In order to preserve its heritage, a replica of the monument is being opened about 1 kilometer away from the actual burial site.Specialists have recorded every detail of Tutankhamun's tomb and used the data to recreate it.
Adam Lowe from the organization behind the project says the copy is identical to the original.He believes visitors will want to become part of the force that protects it rather than a force that is leading to its destruction.So they won't mind seeing a replica.
But for historian Tom Holland, a copy is still a copy.He believes that although preservation is important, there is something unique about places like Tutankhamun's tomb.He says it was built by people who believed in the world of the spirits, the dead and the supernatural.You don't have to believe in a god or gods to feel a place is consecrated and has a particular quality that can't be reproduced.
What about you? Would you visit a replica of a monument rather than the original to help preserve it? [/INST] question: What may account for the destruction of some archaeological treasures like Tutankhamun's tomb? | options: A: Climate change B: Copies C: Popularity D: Thieves | answer: C </s> |
<s>[INST] context: CoA biosynthesis requires cysteine, pantothenate (vitamin B5), and adenosine triphosphate (ATP).it is naturally synthesized from pantothenate (vitamin B5), which is found in food such as meat, vegetables, cereal grains, legumes, eggs, and milk.Pantothenate (vitamin B5) is phosphorylated to 4'-phosphopantothenate by the enzyme pantothenate kinase (PanK; CoaA; CoaX). This is the committed step in CoA biosynthesis and requires ATP.A cysteine is added to 4'-phosphopantothenate by the enzyme phosphopantothenoylcysteine synthetase (PPCS; CoaB) to form 4'-phospho-N-pantothenoylcysteine (PPC). This step is coupled with ATP hydrolysis.PPC is decarboxylated to 4'-phosphopantetheine by phosphopantothenoylcysteine decarboxylase (PPC-DC; CoaC)4'-phosphopantetheine is adenylylated (or more properly, AMPylated) to form dephospho-CoA by the enzyme phosphopantetheine adenylyl transferase (PPAT; CoaD)Finally, dephospho-CoA is phosphorylated to coenzyme A by the enzyme dephosphocoenzyme A kinase (DPCK; CoaE). This final step requires ATP. [/INST] question: Coenzyme A is formed from which vitamin? | options: A: C B: B4 C: Nicotinic acid D: Pentothenic acid | answer: D </s> |
<s>[INST] context: What can help you make a fortune in the future? Graduating from a top university might not be enough. A new study from the University of Essex in Britain has shown that the more friends you have in school, the more money you'll earn later.
The idea that popularity could have a serious impact on one's earning potential shouldn't come as too much of a surprise. The researchers noted that if you want to get ahead in life, social skills and networking are easily as powerful as talent and hard work.
"If a person has lots of friends, it means that he or she has the ability to get along with others in all kinds of different situations," said Xu Yanchun, 17, from Nantou High School in Shenzhen, who totally agreed with the recent finding. "Also, friends always help each other. They not only create wider social circles for you but lift your mood when you occasionally feel depressed," said Xu. She believed that all this helps you "earn a higher salary".
Maybe that's why some people think the younger generations are in the age of Friendalholism . A woman even complained that the networking website Facebook's 5,000-friend limit was too low for her large reserve of social contacts.
But what does a friend mean? Should friends be regarded as a form of currency?
"Call me uncool, but I think of a friend as an actual person with whom I have an actual history and whom I enjoy actually seeing. It seems, however, that this is no longer the definition of 'friend'," said Meghan Daum, who works with the Los Angeles Times in the US. [/INST] question: The new study from the University of Essex in Britain shows that _ . | options: A: if you have more friends you will not live happily B: the more friends you have in school, the more money you'll earn in your late life C: the less friends you have, the poor lives you will live D: friends can make more money for you | answer: B </s> |
<s>[INST] context: Dens in Dente
(Dens invaginatus, dilated composite odontome)
The ‘dens in dente’ is a developmental variation which is thought to arise as a result of an invagination in the surface of tooth crown before calcification has occurred. Several causes of this condition have been proposed. These include increased localized external pressure, focal growth retardation, and focal growth stimulation in certain areas of the tooth bud. The permanent maxillary lateral incisors are the teeth most frequently involved, and in the majority of cases the ‘dens in dente’ appears to represent simply an accentuation in the development of the lingual pit.
Radiological signs
Dens in dente represent a tooth-shaped, enamel-covered mass within the crown and/or root of the tooth but which may traverse the length of the tooth. Dilated odontome represents the most extreme form of this anomaly and exhibits a grossly altered morphology that is internally outlined by a dense linear radiopacity. In both cases, the apical region may or may not display an open apex and there may be associated adjacent apical rarefaction. [/INST] question: The specific name of the anomaly shown in the following radiograph is: | options: A: Dens in dente B: Dilated odontome C: Dens invaginatus D: Ghost tooth | answer: B </s> |
<s>[INST] context: Welcome to France! Here are some places of interest in Paris.
Louvre Museum
The collection of the Louvre Museum was first established in the 16th century as the private collection of King Francis I. One of the works of art he purchased was the now famous Mona Lisa painting. The collection grew steadily thanks to donations and purchases by the kings. In 1793, during the French Revolution, the Louvre became a national art museum and the private royal collection opened to the public. The museum has a collection of over 1 million works of art, of which about 35 000 are on display, spread out over three wings of the former palace. The museum has a diverse collection ranging from ancient times up to the mid 19th century.
Wine Tasting
French Wine Tasting in Paris: Whether you are a wine beginner or a real experienced one, one of these tastings is for you! You will taste a wonderful variety of French wines: from Alsace to Bordeaux, from Burgundy to Chateauneuf-du-Pape. With an unusual approach, focused on fun and joy, your French sommelier will allow you to learn and enjoy the pleasures of wine!
There are different ways of tasting to choose from and each is unique, like Wine Appreciation Class, French Wine Regions Presentation, Reading a French Label and the possibility to buy wine. Your Wine Tasting takes place at a French sommelier's home, in a beautiful loft with air conditioning.
Lido Show
This evening will begin with the abundant recipes which have been styled in cooperation with the famous French chef, Paul Bocuse. The orchestra invites you to the dance floor. At 9:30pm the Lido's curtain rises for a non-stop hour of magic... as performance after performance bursts onto the stage. After dinner, you'll discover the Lido's unique show. Special effects, incredible settings, magnificent costumes, the display of lights, music rhythms and exceptional entertainments are all pure enchantment. Book your tickets for the Lido dinner show in advance on our website. [/INST] question: When did the Louvre Museum become open to the public? | options: A: in the 16th century B: in the 17th century C: in the 18th century D: in the 19th century | answer: C </s> |
<s>[INST] context: Winter is a very special time in Northern Norway. Winter also means skiing, and Narvik can offer some of the best skiing in Norway. The view and light change frequently and no two days are the same. For many people, the northern lights are an unforgettable sight, and in Narvik the sky is especially clear and great for watching at night.
The tourist season lasts from February to April, although May can be fascinating too, often with fantastic dry snow and an unbelievable light lasting well into the evening.
Ski hire
It is possible for adults and children to hire skiing equipment such as snowboards. All equipment is prepared for us. If you would like to book your equipment, please email Narvikfjellet.
Cross-country skiing
There are 12 kilometers of cross country ski run in Narvik. You need to bring your own skis as there is no cross-country hire. However, equipment can be bought at local sports shops in and around Narvik.
Off-piste skiing
In order to explore Narvik's off-piste opportunities you need to know the dangers when choosing routes. It is suggested that you bring necessary equipment such as a shovel and a GPS locator. Ask Narvikfjellet for an experienced guide. With a guide you can explore Narvik's special off-piste areas in a safe manner.
Sometimes it is nice to do something different and not everybody enjoys skiing. Then you can go horse-riding, or visit the local museums.
Price examples for the 2013--2014 season
Time Children(8-15 years old) Adults
1 day NOK 230 NOK 325
3 days NOK 590 NOK 835
5 days NOK 815 NOK 1,170
7 days NOK 970 NOK 1,375
Children 0-7 years can enjoy the service for free [/INST] question: . In Northern Norway, the tourist season may last _ . | options: A: one month B: two months C: three months D: four months | answer: C </s> |
<s>[INST] context: The anion gap is equal to the difference between the plasma concentration of sodium, the major cation in the plasma, and the sum of the concentrations of plasma chloride and bicarbonate, the major measured anions in the plasma.Anion gap = - ( + )The normal plasma concentrations of Na+, Cl-, and HCO3- are 142, 105, and 24 mEq/L, respectively.The normal anion gap is about 12 mEq/L and is comprised of minor ions, such as lactate, phosphate, and sulfate.The anion gap is useful in differentiating the causes the metabolic acidosis.High anion gap metabolic acidosis results from an increase in unmeasured organic anions, such as occurs in the lactic acidosis accompanying tissue hypoxia, the accumulation of ketoacids in diabetes and its resultant coma, or by an increase in organic anions or their metabolic byproducts produced from such ingested toxins as ethylene glycol, methanol, and salicylates.COPD and myasthenia gravis are causes of respiratory acidosis. Nasogastric suctioning causes metabolic alkalosis. [/INST] question: Which of the following is associated with an increased anion gap? | options: A: Myasthenia Gravis B: Chronic obstructive pulmonary disease C: Diabetic coma D: Nasogastric suctioning | answer: C </s> |
<s>[INST] context: The world's greatest detective, Sherlock Holmes, is back on our screens.
The new BBC TV series of Sherlock was broadcast in the UK on Jan 1. But the history of Sherlock dates back 127 years.
Since the creation of Holmes in 1887, he has been taking us on adventures one after another.
The Sherlock series is a playful drama, covered in crimes and mystery. It gives us a modern Sherlock for a new generation, who solves cases with the help of the Internet, cell phones and GPS.
People look to Sherlock for both adventure and inspiration . Each case sends us on a mysterious journey with Holmes. The stories give life and color to our imagination: as he checks the crime scene, we join him and become detectives too, looking out for hidden clues.
Yet Holmes is no Superman. He cannot fly, or turn invisible . But his powers are within all of us: reason, logical thinking and paying attention to detail. While an artist's painting is his art, Sherlock's art is his intelligence . He is human, and this is what makes Holmes a true hero for all of us.
In the new series of Sherlock, most people thought Holmes was dead. But he returns after two years of hiding in the shadows. Now the whole city of London is in danger. What can Holmes possibly do? Uncover the mystery yourself by watching the new series! [/INST] question: Sherlock was created in _ . | options: A: 2014 B: 1973 C: 1887 D: 1900 | answer: C </s> |
<s>[INST] context: LEEP Repeat All India 2009 "Although CIN can be treated with a variety of techniques, the preferred treatment for CIN 2 and 3 has become LEE?" - Novak's Gynecology p582 Though the patient is 35 yrs old and has completed her family, still hysterectomy won't be treatment of choice as-"Hysterectomy is currently considered too radical .for treatment of CIN"Novak's Gynecology p.585 Following are some situations in which hysterectomy remains a valid and appropriate method of treatment for CIN Microinvasion CIN 3 at limits of conizution specimen in selected patients Poor compliance with follow-up Other gynecologic problems requiring hysterectomy, such as fibroids, prolapse, endometriosis, and pelvic inflammatory disease Cervical intraepithelial neoplasia(CIN) Invasive squamous cell cervical cancers are preceded by a long phase of preinvasive disease, collectively referred to as cervical intraepithelial neoplasia (CIN). Histopathologically a pa or the full thickness of cervical squamous epithelium is replaced by cells showing varying degree of dysplasia, with intact basement membrane. CIN may be suspected through cytological examination using the Pap smear test or through colposcopic examination. Cervical cytology is the most efficacious and cost-effective method for cancer screening. Final diagnosis of CIN is established by the histopathological examination of a cervical punch biopsy or excision specimen. Additionally, human papilloma virus (HPV) testing can be performed in order to better triage women with early cytologic changes. Cervical Cytology Screening (American College of Obstetricians and Gynecologists Guideline) Initial screening Age 21 or 3 y after vaginal sex Interval Every year Every 2-3 y after age 30 with 3 consecutive normals Discontinue No upper limit of age Comparison of Cytology Classification Systems (in simplified form) Bathesda CIN llysplasia Limit of histologic changes *LSIL CIN 1 Mild Basal 1/3rd of sq. epithelium HSIL ON 2 Moderate Basal 1/2 to 2/3rd CIN3 Severe Whole thickness except one or two superficial layers CIS Whole thickness LSIL - Low grade squamous intraepithelial lesion HSIL - High grade squamous intraepithelial lesion CIS - Carcinoma in situ *LSIL incorporates HPV changes (koilocytotic atypia) along with CIN I. Role of HPV HPV infection is found in approx. 90% cases of intraepithelial neoplasia. Type H&18 are most commonly associated. HPV-18 is more specific than HPV-16 for invasive tumors. In most women, the HPV infection clears in 9 to 15 months. Only a minority of women exposed to HPV develop persistent infection that may progress to CIN. Type-16 is the most common HPV type found in women with normal cytology. Treatment CIN 1 Spontaneous regression of CIN 1 is seen in 60% to 85% of cases, typically within 2yrs. So patients who have biopsy diagnoses of C1N 1 are kept under observation with: Pap testing performed at 6 and 12 months Or HPV DNA testing at 12 months After two negative test results or a single negative HPV DNA test, annual screening may be resumed. Women with persistent CIN 1 after 24 months should be treated with a local ablative method. CIN 2 and3 CIN 2&3 carries a much higher probability of progressing to invasive cancer. All CIN 2 and 3 lesions require t reatment. LEEP ( loop electrosurgical excision procedure) is the preferred treatment for CIN 2 and 3. Because all therapeutic modalities carry an inherent recurrence rate of upto 10%. cytologic follow-up at about 3-month intervals for 1 year is necessary. Cryotherapy Considered acceptable therapy when the following criteria are met: - Cervical intraepithelial neoplasia, grade 1 to 2 - Small lesion Ectocervical location only - Negative endocervical sample - No endocervical gland involvement on biopsy Laser Ablation It has been used effectively for the treatment of CIN .But because of the expense of the equipment as well as necessity for special training, laser ablation has fallen out of or. Laser has been widely replaced by LEEP. Laser Excisional Conization Rather than using laser for vaporization leading to ablation, it can be used to excise a conization specimen. The ease of LEEP conization has significantly reduced the indications of laser conization. Loop electrosurgical excision( LEEP) LEEP, variably known as simply loop excision or LLETZ (large loop excision of the transformation zone), is a valuable tool for the diagnosis and treatment of CIN. It uses low-voltage, high-frequency, thin wire loop electrodes to perform a targeted removal of a cervical lesion, an excision of the transformation zone, or a cervical conization. This technique can be used in the outpatient setting Cold knife conization (scalpel) Conization is both a diagnostic and therapeutic procedure and has the advantage over ablative therapies of providing tissue for fuher evaluation to rule out invasive cancer. Conization is indicated for CIN 2&3 in following conditions: - Limits of the lesion cannot be visualized with colposcopy. - The squat-no-columnar junction (SCE) is not seen at colposcopy. - Endocervical curettage (ECC) histologic findings are positive for CIN 2 or CIN 3. - There is a substantial lack of correlation between cytology, biopsy, and colposcopy results. - Microinvasion is suspected based on biopsy, colposcopy, or cytology results. - The colposcopist is unable to rule out invasive cancer. [/INST] question: A 35 yr old P 3+0 is observed to have CIN grade III on colposcopic biopsy. Best treatment will be | options: A: Cryosurgery B: Conization C: LEEP D: Hysterectomy | answer: C </s> |
<s>[INST] context: Friend, there are two aspects which should be considered while answering such a question.
Best time for diagnosis
Earliest time of detection.
In case of anencephaly:
“The diagnosis may be suspected in the first trimester during examination with endovaginal probe but it is usually not certain until after 14 weeks.”
Fernando Arias 3/e, p 64
“Anencephaly can theoretically be diagnosed as early as 8 weeks; however it can be missed in the first trimester. In the second trimester, if an adequate ultrasound examination can be performed, anencephaly is diagnosed with virtually 100% accuracy.”
Williams Obs. 21/e, p 1120
“It can be diagnosed in the late first trimester and with adequate visualization, virtually all cases may be diagnosed in the second trimester”.
Williams Obs. 23/e, p 354
Anencephaly -
“Although fetal head can be positively identified by vaginal sonography as early as the 7th week of gestation, the diagnosis may be difficult in the first trimester. The diagnosis is easy in the midtrimester.”
Callen, Ultrasound in Obs. & Gynae 4/e, p 284 [/INST] question: Accurate diagnosis of anencephaly in ultrasound is seen at week: | options: A: 6 weeks of gestation B: 8 weeks of gestation C: 10 weeks of gestation D: 14 weeks of gestation | answer: D </s> |
<s>[INST] context: Pasta is the world's favorite food. Asurveytaken in 17 countriesconfirmedthat pasta is what people like to eat most. Not only is pasta the number one food in its home country -Italy, but is alsoenjoyedin faraway places like the Philippines, Mexico andSouth Africa.
Pasta has become popular, for one thing, because it is cheap and easy to prepare. Just cook noodles or other forms of pasta, make a sauce to go with it and you're finished. Many different types of meals can becreatedwith pasta. It tastes good and fills your stomach. It produces energy in the form ofcarbohydrates , which is whyathleteseat pasta regularly. Pasta can also be kept for a longer time. You don't have to use it up at once.
Pasta has also become popular because it stands for the Italian way of life. People all over the world like it because it's so simple. It has two basic ingredients , wheatand water, just like bread.
Legend has itthat Marco Polo brought pasta back to Italy with him but this is not true. Arabs probably brought a noodle-likedishtoSicilyin the 8th century. Farmers have been growing wheat, the mainingredientof pasta, there for ages.
The worldwide sales of pasta have risen sharply over the past decade. Italy leads the pasta-eatingcommunityof the world. The Italians are the number one consumers followed by Venezuela and Tunisia. [/INST] question: In which country do people eat pasta most? | options: A: Mexico B: Venezuela C: The Philippines D: South Africa | answer: B </s> |
<s>[INST] context: The coast of the State of Maine is one of the most irregular in the world. A straight line running from the southernmost coastal city to the northernmost coastal city would measure about 225 miles. If you followed the
coastline between these points, you would travel more than ten times as far. This irregularity is the result of what is called a drowned coastline. The term comes from the glacial activity of the Ice Age. At that time, the whole area that is now Maine was part of a mountain range that towered above the sea. As the glacier descended, however, it applied enormous force on those mountains, and they sank into the sea.
As the mountains sank, ocean water charged over the lowest parts of the remaining land. And the highest parts of the former mountain range, nearest the shore, remained as islands. Marine fossils found here are 225 feet above sea level indicating the level of the shoreline prior to the glacier.
The 2,500-mile-long rocky and jagged coastline of Maine keeps watch over nearly 2,000 islands. Many of these islands are tiny and uninhabited, but many are home to blooming communities. Mt. Desert Island is one of the largest, most beautiful of the Maine coast islands left behind by the glacier. Measuring 16 miles by 12 miles, Mt. Desert was very nearly formed as two distinct islands. It is split almost in half by Somes Sound, a very deep and very narrow stretch of water seven miles long.
For years, Mt. Desert Island, particularly its major settlement, Bar Harbor, has afforded summer homes for the wealthy. Recently, though, Bar Harbor has become a new arts community as well. But the best part of the island is the unspoiled forest land known as Acadia National Park. Since the island sits on the border between two different geographical zones, the park supports the plants and animals of both zones. It also lies in a major bird migration lane and is a resting spot for many birds.
The establishment of Acadia National park in 1916 means that this natural monument will be preserved and that it will be available to all people, not just the wealthy. Visitors to Acadia may receive nature instruction from the park naturalists as well as enjoy camping, hiking, cycling, and boating. Or they may choose to spend time at the museum learning about the Stone Age inhabitants of the island. [/INST] question: The large number of small islands along the coast of Maine is the result of _ . | options: A: the drowning of the Maine coastline B: glacier's forcing mountains into the sea C: the irregularity of the Maine coastline D: ocean water's flooding the mountain range | answer: B </s> |
<s>[INST] context: I've been working in a school for more than twenty years .Many parents often ask me ,"How can you teach your child good study skills ? How can he or she get the homework done as quickly as possible ? "Here are some tips :
1.If the child is as young as nine or ten ,ask him or her to prepare a small notebook to write down the homework given by his or her teachers .By developing this habit ,he or she will learn to be much more responsible .
2.Find a good place to study .This should be a quiet place that is free from everything but study things .No games ,radios ,or televisions .Once you have decided on a place to study ,this should be the only place where your child does his or her homework and studies .There should also be a very specific time for homework to be done .Usually ,homework should be done as soon as the child gets home from school .This also goes for the kids who take part in afterschool activities .Of course ,it is a good idea to allow the child to have a healthy snack before the work begins .
3.Also remember that it is the child's duty to do his or her homework .Some children give up easily and go to Mom and Dad for help when they have a problem .Try to let them solve it first .By doing this ,they will get a sense of success from overcoming problems .In this way we help them to help themselves . [/INST] question: Asking the kids to keep a notebook to remember their homework will make them _ . | options: A: remember more B: learn more C: more responsible D: more interested in studying | answer: C </s> |
<s>[INST] context: Try reading the following sentences as fast as you can. " She sells seashells by the seashore. The shells she sells are surely seashells. So if she sells shells in the seashore, I'm sure she sells seashore shells."
Not very easy, was it? What you've just read is called a tongue twister . It is an exercise made up of sounds that are hard to pronounce in order to help people pronounce words faster and more correctly. Try the next example.
"Peter Piper picked a peck of picked peppers, Did Peter Piper pick a peck of picked peppers? If Peter Piper picked a peck of picked peppers, where's the peck of picked peppers Peter picked?"
Tongue twisters usually do not have much meaning. They are just designed to improve people's _ to pronounce words. Although they may be very difficult, these exercises are very important to people who are trying to speak English correctly. This is because tongue twisters help people to tell the differences between similar sounds.
So if you wish to pronounce words more smoothly, you'd better try picking out some tongue twisters and practicing them. [/INST] question: Tongue twisters are helpful in improving _ skills. | options: A: listening B: writing C: pronunciation D: communication | answer: C </s> |
<s>[INST] context: The enzyme functions by attacking peptidoglycans (found in the cell walls of bacteria, especially Gram-positive bacteria) and hydrolyzing the glycosidic bond that connects N-acetylmuramic acid with the fouh carbon atom of N-acetylglucosamine. It does this by binding to the peptidoglycan molecule in the binding site within the prominent cleft between its two domains. This causes the substrate molecule to adopt a strained conformation similar to that of the transition state. According to Phillips-Mechanism, the lysozyme binds to a hexasaccharide. The lysozyme then distos the fouh sugar in hexasaccharide (the D ring) into a half-chair conformation. In this stressed state, the glycosidic bond is easily broken. The amino acid side-chains glutamic acid 35 (Glu35) and aspaate 52 (Asp52) have been found to be critical to the activity of this enzyme. Glu35 acts as a proton donor to the glycosidic bond, cleaving the C-O bond in the substrate, whereas Asp52 acts as a nucleophile to generate a glycosyl-enzyme intermediate. The glycosyl-enzyme intermediate then reacts with a water molecule, to give the product of hydrolysis and leaving the enzyme unchanged [/INST] question: Which of the following causes hydrolysis of Peptidoglycans? | options: A: Lysozyme B: Lactoferrin C: Protease D: Aflatoxin | answer: A </s> |
<s>[INST] context: This is miller laryngoscope used for pediatric intubation to lift up the whole epiglottis . The straight Miller laryngoscope blade is traditionally recommended for intubation in infants, due to the large size and flexibility of the infant epiglottis. A laryngoscope is an instrument used to examine the larynx. The classic laryngoscope is available with a variety of blade attachments and with/without a Fiber Optic light source. The trend regarding blades has/is moving toward the disposable version. Function:Laryngoscope blades are used as the primary tool for examination of the interior of the larynx and for placement of an endotracheal tube.Main Feature:The Miller Laryngoscope Blade . . . The most popular of the straight types. The side of the flange is reduced to minimize trauma and the curve at the beak or tip is extended to improve lifting of the epiglottis. These improvements facilitate greater exposure of the larynx in difficult-to-intubate patients. The Macintosh Laryngoscope Blade . . . The Macintosh is the predominate model of the curved blade types. During laryngoscopy, the tip or beak of the blade is compressed into the angle formed by the base of the tongue and the epiglottis, indirectly raising the epiglottis. Some sizes are available flangeless. Also available is a die-stamped or one-piece construction blade with a slightly expanded flange. [/INST] question: This laryngoscope is paicularly used for:- | options: A: Pediatric inubation B: Difficult airway C: Nasal intubation D: Rapid sequence intubation | answer: A </s> |
<s>[INST] context: Noonan Syndrome :
were previously thought to have a form of Turner syndrome, with which Noonan syndrome shares a number of clinical features.
The observation that patients with Noonan syndrome have normal karyotypes was important in allowing the distinction to be made between the Turner and Noonan syndromes.
Pathophysiology :
The pathophysiology of Noonan syndrome is not fully understood. A disease-causing gene, PTPN11, has been identified. The gene product, SHP2, plays an important role in cardiac semilunar valve development.
Sex :
Noonan syndrome occurs in either a sporadic or autosomal dominant fashion. In either case, males and females are affected equally.
Age :
The disorder is present from birth, but age impacts upon the facial phenotype Infants with Noonan syndrome can be difficult to recognize by facial appearance alone. The phenotype becomes more striking in early childhood, but with advancing age, it may again become quite subtle. Careful examination of an affected child's parents may, in fact, reveal that they are affected mildly.
Clinical features -
Growth parameters
Size at birth is usually within the reference range.
Short stature is present in up to 80% of patients. Average adult height for males is 5'55" and for females is 5'.
Facial features
Triangular-shaped face
Hypertelorism
Down-slanting eyes
Ptosis
Strabismus
Amblyopia
Refractive errors
Low-set ears with thickened helices
High nasal bridge
Short webbed neck
Chest/back features
Pectus carinatum/excavatum
Scoliosis
Cardiac features
The characteristic lesion is a dysplastic/stenotic pulmonic valve, but virtually all types of congenital heart defects have been described in patients with Noonan syndrome.
Hypertrophic cardiomyopathy (obstructive and nonobstructive types) is present in up to 30% of patients.
Abdominal features
Hepatosplenomegaly unrelated to cardiac status is present in approximately 25% of patients.
Genitourinary features
Renal anomalies are present in 10% of patients but are not clinically significant.
More than half of male patients have undescended testes.
Skeletal features
Joint laxity is present in more than half of patients.
Talipes equinovarus, radioulnar synostosis, cervical spine fusion, and joint contractures are less common findings.
Skin findings
Lymphedema
Prominent pads of fingers and toes
Follicular keratosis of the face and extensor surfaced
Multiple lentigines
Neurologic findings
Hypotonia
Seizure disorder
Unexplained peripheral neuropathy (infrequent) [/INST] question: Cardiac abnormality seen with Noonan's syndrome is - | options: A: VSD B: ASD C: Pulmonary stenosis D: Coarctation of aorta | answer: C </s> |
<s>[INST] context: Angry survivors demanded answers on Sunday after a terrible stampede at "Love Parade 2010", a music festival in Germany, killed 19 people and left hundreds hurt.
The German Chancellor Angela Merkel expressed her shock over Saturday's tragedy in the western city of Duisburg. "This was a very sad day," Merkel said. "We must do everything we can to ensure that something like this never happens again."
Witnesses said that people pushed into the narrow tunnel, the only entrance to the Love Parade festival, from both sides until it was dangerously overcrowded. The panic began as festival-goers began to lose consciousness as they were crushed against the walls and each other. The dead included eight foreigners, from Australia, Italy, the Netherlands, China, Bosnia and Spain. More than 340 people were injured.
After the panic, a lot of emergency vehicles, including helicopters, could be seen parked on the highway leading to helicopters, could be seen parked on the highway leading to the festival site, carrying away the injured people. The festival itself, however, went on. Police were afraid that ending the music altogether could cause further unrest among the crowd.
"The event was a real mess," Patrick Guenter, a 22-year-old baker, said. "Although the festival was full, they kept letting people in." he added. "It seems the organizers didn't plan the route. The road was very narrow, and no one knew what was going on." Said Taggart Bowen-Gaddy,20,an American from Philadelphia.
Officials said 4,000 police officers and 1,000 security guards provided security for the event, which attracted up to 1.4 million people. The authorities had only given organizers permission for 250,000 people to attend.
"I warned one year ago that Duisburg was not a suitable place for the Love Parade. The city is too small and narrow for such events. It is a pity that..." German police union chief Rainer Wendt told the Bild.
The chief organizer, Rainer Schaller, said the popular event would never be held again, "out of respect for the victims and their families".
First held in Berlin in 1989 just months before the fall of the Wall, the Love Parade is one of the biggest music festivals in Europe. It left Berlin from 2007 onwards after disagreements with the city authorities over security and has been held in several other German cities in recent years. [/INST] question: How did the German Chancellor Angela Merkel feel about the tragedy? | options: A: Very disappointed B: Angry and surprised C: Very puzzled D: Touched | answer: B </s> |
<s>[INST] context: Anne and Joseph are talking about an interesting question. Why do some people change their names? There can be many reasons. Hanna changed her name to Anne because she thought it would be easier for people to remember. On the other hand, Joseph is thinking about changing his name to an unusual name because he wants to be different.
People have a lot of reasons for changing their names. Film stars, singers, sportsmen and some other famous people often change their names because they want names that are not ordinary, or that have special sound. They chose the "new name" for themselves instead of the name their parents gave them when they were born.
Some people have another reason for changing their names. They have moved to a new country and want to use a name that is usual there. For example, Li Kaiming changed his name to Ken Lee when he moved to the United States. He uses the name Ken at his job and at school. But with his family and Chinese friends, he uses Li Kaiming. For some people, using different names makes life easier in their new country.
In many countries, a woman changes her family name to her husband's after she gets married. But today, many women are keeping their own family name and not using their husband's. Sometimes, women use their own name in some situations and their husband's in other situations. And some use both their own name and their husband's. [/INST] question: Hanna changes her name to Anne because "Anne" is _ for people to remember. | options: A: louder B: easier C: prettier D: harder | answer: B </s> |
<s>[INST] context: A Special Opportunity for Customers of Producers Choice
Dear music producers,
If you LOVE producing music, then you are going to LOVE our new monthly sample pack club. With Producers Choice Monthly, you'll get every single sample pack we'll ever make at theproducerschoice.com. You'll get every new pack we put on the website -- sent directly to your email inbox even before they go on our website! Also, you'll get a new sample pack (worth $36) to get started immediately.
Other Benefits:
Only $29.95 per month.
Cancel the order anytime you like.
Get sample packs that NO ONE else will get.
Keep your inspiration flowing with new samples each month.
I'm excited to be able to offer this subscription service to both new and existing customers. I hope you are looking forward to taking your music to the next level with our award-winning samples being sent to you each month -- good for keeping your inspiration flowing.
3 (8 )
Frequently Asked Questions (FAQs) about Producers Choice Monthly:
Q -- How many sample packs will I get with my subscription?
A -- You'll usually get 1--3 new sample packs per month. The sample packs are different in size, each of which is usually from 300MB to 2GB+, so you will get great value for money!
Q -- How will my samples be delivered to me?
A -- We send our members an email with a download link, so you can download your sample packs quickly and easily.
Q -- How does the payment/billing work?
A -- If you join our monthly plan, your credit card will be billed once a month. You can stop at any time. [/INST] question: The website the producers choice.com. is most probably for _ . | options: A: music producers B: email writers C: credit card users D: web designers | answer: A </s> |
<s>[INST] context: Here are some of the movies that inspire you to travel.
The Lord of the Rings
The story is about Frodo, his friends and their adventurous journey through Middle Earth. Filmed in about 150 locations all over New Zealand, this traveling movie shows its beauty. From the rolling hills of Matamata to the volcanic retrion of Mt Ruapehu, this is the best movie o see New Zealand . Also, this travel movie might have the only distinction of being inspired by ravel too. The director of the movie Peter Jackson first read the novel on a train going from ellington to Auckland when he was just seventeen.
Indiana Jones. The Complete Adventure Collection
Indiana Jones and travel are inseparable. Everyone remembers the red line on the world map that shows up on screen when he flies. The Egypt scenes in Raiders of the Lost Ark were filmed in Tunisia. Temple of doom was filmed mostly in Sri Lanka and Macau. The Last Crusade was filmed in Italy , Spain and Jordan including an excellent view of Petra. Unlike the other, Kingdom of the Crystal Skull was filmed almost entirely in the United States. However, their shots of Iguazu Falls are amazing.
Romancing the Stone and jewel of the Nile
This movie series focuses on a romance writer Joan and her adventures with a soldier of fortune named Jack. In Romancing the stone Joan goes to Colombia to save her sister who was kidnapped . In the sequel Joan goes to the fictional kingdom of Kadir set somewhere in the Middle East. Romancing the stone's scenes were shot mostly in Mexico. For Jewel of the Nile, the scenes were mostly shot in France and Morocco.
The Telented Mr Ripley
Tom Ripley is a working class young man. Through a case of mistaken identity, he is asked to go to Italy to convince a wealthy businessman's son to come home. This travel movie starts in New York and heads to the fictional resort of Mongibello . The last section of the movie is filmed mostly in Rome and Naples. The locations are beautiful. They also did a good job of showing Italy as it looked in the 1960s. [/INST] question: If someone is interested in seeing views in Sri Lanka, he / she would most probably_watch the film | options: A: Temple of Doom B: The last Crusade C: Raiders of the lost Ark D: Kingdom of the Crystal Skull | answer: A </s> |
<s>[INST] context: At 10 years old, Flynn Mc Garry became sick of the meals his mother cooked for him. So the Los Angeles native took matters into his own hands and started making his own dinners. One of his specialties? Trout with braised leeks .
Now 13, the young chef is being praised as a "food prodigy ". He will spend his summer apprenticing with some of the best chefs at LA's famous restaurants, MSNBC Nightly New reports.
Mc Garry began making a name for himself in the culinary world when John Sedlar, owner of the trendy Playa Restaurant, let Mc Garry take over the kitchen for a special nine-course meal. The meal sold out almost instantly.
"Flynn is a very unusual young man, and he's very, very passionate," owner John Sedlar told MSNBC.
By usual teenage boy standards, it's true. So strong is his passion for cooking that the young man has turned his bedroom into an experimental kitchen laboratory.
Instead of video game consoles, baseball trophies and movie posters, Mc Garry's room is lined with mixers, pots and pans, cutting boards and a stainless steel worktable. It's where Mc Garry cooks his monthly pop-up dinners, which are served from his family's dining room, a monthly supper club he calls Eureka.
Mc Garry is deft and confident in the kitchen, with skills he's been practicing since he was a child. What started out as a means of self-preservation from his mom's unsatisfactory cooking has turned into a passion that the teen hopes to develop into a career.
"My goal? Michelin three stars, a restaurant in the top 50 list," he told MSNBC. "Hopefully the top five." Meanwhile, Mc Garry's 13-year-old resume is already richer and more impressive than most cooks many times his age.
Mc Garry isn't the only talented young prodigy to surprise experts in his field in recent years. At just 17 years old, physicist Taylor Wilson is already teaching graduate-level courses in physics and has built a functioning nuclear reactor. [/INST] question: Mc Garry first started cooking _ . | options: A: for himself B: as an experiment C: in his own bedroom D: with a teacher's guidance | answer: A </s> |
<s>[INST] context: Chorionic gonadotropin is a glycoprotein with biological activity similar to that of LH Both LH and HCG act the same LH-hCG receptor. hCG has with a molecular weight of 36,000 to 40,000 Da It has the highest carbohydrate content of any human hormone--30 percent. The 36-hour plasma half-life of intact hCG is much longer than the 2 hours for LH. The hCG molecule is composed of two dissimilar subunits termed a and b subunits. hCG is produced almost exclusively in the placenta, but low levels are synthesized in the fetal kidney. The hCG hormone is structurally related to three other glycoprotein hormones --LH, FSH, and TSH. All four glycoproteins share a common a-subunit.However, each of their b-subunits, although sharing ceain similarities, is characterized by a distinctly different amino acid sequence. A single gene located on chromosome 6 encodes the a-subunit. Seven genes on chromosome 19 encode for the b-hCG-b-LH family of subunits. Six genes code for b-hCG and one for b-LH Before 5 weeks of pegnancy, hCG is expressed both in the syncytiotrophoblast and in cytotrophoblasts. Later, in the first trimester when maternal serum levels peak, hCG is produced almost solely in the syncytiotrophoblast The combined hCG molecule is detectable in plasma of pregnant women 7 to 9 days after the midcycle surge of LH that precedes ovulation. Thus, hCG likely enters maternal blood at the time of blastocyst implantation. Plasma levels riserapidly, doubling every 2 days in the first trimester Peak maternal plasma levels reach approximately 50,000 to 100,000 mIU/mL between the 60th and 80th days after menses. At 10 to 12 weeks' gestation, plasma levels begin to decline, and a nadir is reached by approximately 16 weeks. Plasma levels are maintained at this lower level for the remainder of pregnancy. The principal urinary form is the terminal product of hCG degradation, namely, the b-core fragment. Concentrations of this fragment follow the same general pattern as that in maternal plasma, peaking at approximately 10weeks' gestation. The best-known biological function of hCG is the so-called rescue and maintenance of corpus luteum function--that is, continued progesterone production. Other hCG functions include promotion of relaxin secretion by the corpus luteum [/INST] question: Beta HCG is secreted by: | options: A: Yolk sac B: Liver C: Syncytiotrophoblast D: Umbilical cord | answer: C </s> |
<s>[INST] context: Tabb doesn't look like a typical music teacher. But every weekday evening in the French Quarter New Orleans, he beats out the rhythm on his music stand as students play their chosen instruments.
"I'm doing my best to take young people away from harmful things," said Tabb. His program, "The Roots of Music", offers free music education to more than 100 students. He struggles to _ in the city with the nation's highest murder rate .
Tabb chose to target 9to14yearolds with his program. "That's a very important time in your life," he said. "If I catch them then, I can hold onto them for at least four or five years and guide them the way that will lead them to success."
Students meet from 4 pm to 7 pm every weekday, all year round. They work with tutors on schoolwork, practice their music and eat a hot meal before heading home. With the money provided by some people, Tabb's group is able to provide bus transportation, instruments and food for free. He calls it his "no excuse" policy. "You have no excuse why you're not here," Tabb said. Tabb owes the success in part to the nature of music. "You're always learning something new,"he said. "That's what keeps the kids coming back every day."
But the program isn't only about fun. "Music is about discipline ,"said Tabb. He insists on good behavior and keeps kids in order with threats of situps , pushups or tasks like picking up grains of rice -- but these measures aren't just punishment. Tabb wants young people to realize that music can help them build a better future. "I don't say that I'm saving lives," he said. "I say I'm giving life -- a whole different life of music." [/INST] question: Which of the following kids may NOT be included in Tabb's program " The Roots of Music"? | options: A: Jack, 8 years old B: Tom, 9 years old C: John, 11 years old D: Linda, 13 years old | answer: A </s> |
<s>[INST] context: Below is some advice on how to prevent cancer:
8 Ways to Avoid Cancer in Your Life
1. Eat Blueberries
Aside from being a healthy and delicious snack, blueberries contain pterostilbene, which has important colon cancer-fighting prosperities. But wait, it gets better. Blueberries also offer a large dose of vitamins C (14 milligrams per cup). So at breakfast, try to take in a cup and a half of blueberries in your cereal or yogurt, or mixed with other berries.
2. Drink Pomegranate Juice
The deep red juice of the pomegranate contains polyphenols, isoflavones and ellagic acid, which together create a powerful anticancer mixture. Most recently, researchers from the University of Wisconsin at Madison has discovered that 16 ounces of pomegranate juice per day also may inhibit the growth of lung cancer.
3. Relax
Feeling stressed or worried? Find ways to relax and you may reduce your chances of developing cancer. Purdue University researchers tracked 1,600 men over 12 years and found that half of those with high levels of worry died during the study period. Only 20 percent of the optimists died before the study were completed, while 34 percent of the extremely anxious men died of some type of cancer. Instead of stressing about the past or future, focus on the present and relax!
4. Take Selenium
Selenium is well known for its cancer-fighting properties. In a study of almost 1,000 men, researchers from the Journal of the National Cancer Institute found that when men with the lowest initial levels of selenium in their bodies received a daily supplement over a 4 year period, they cut their prostate cancer risk by a remarkable 92 percent. However, it is possible to get too much of a good thing, so monitor your intake of selenium-containing supplements, Brazil nuts, tuna, meats and grains carefully.
5. Eat Sushi
Seaweed may not be your idea of a great snack, but it is high in fiber, calcium and iron, and dry, roasted seaweed sheets used in sushi provide the additional benefits of vitamins A and C. Sushi rolls are also high in protein-- a typical spicy tuna roll has only 290 calories but packs 24 grams of protein. So don't skimp on the Sushi!
6. Enjoy the Outdoors
Vitamin D causes early death of cancer cells. A study published in the American Journey of Clinical Nutrition reported that women who supplemented their diets with 1,000 international. Units of vitamin D every day had a 60 percent to 77 percent lower incidence of cancer ever a four-year period that did women taking a placebo . Experts recommend supplementing your fun in the sun with 1,100 to 2,000IU of vitamin D each day.
7. Breathe Clean Air
There's no question that secondhand smoke kills. A recent American Journal of Public Health study showed that nonsmokers working in smoky places had three times the amount of carcinogen in their urine than nonsmokers working in smoke-free locations. What's worse, their levels of the carcinogen rose 6 percent for every hour worked. Nine states have banned smoking in all workplaces, bars and restaurants. The message is clear: Do whatever you can to avoid the cloud of smoke.
8. Break a Sweat
Even a small amount of exercise can offer major cancer-fighting benefits. In a study of 29,110 men published in the International Journal of Cancer, men who exercised just once a week had a percent lower risk of metastasis prostate cancer than men who didn't work out at all. The better the frequency, duration and intensity of the exercise, the bigger the reduction in risk, according to the study. [/INST] question: To prevent yourself from catching colon cancer, you should eat _ as often as possible. | options: A: sushi B: blueberries C: pomegranates D: Vitamin D | answer: B </s> |
<s>[INST] context: He was the baby with no name. Found and taken from the north Atlantic 6 days after the sinking of the Titanic in 1912, his tiny body so moved the salvage workers that they called him "Our baby". In their home port of Halifax, Nova Scotia, people collected money for a headstone in front of the baby's grave, carved with the words: "To the memory of an unknown child." He has rested there ever since.
But history has a way of uncovering its secrets. On November 5 , this year, three members of a family from Finland arrived at Halifax and laid fresh flowers at the grave. "This is our baby," says Magda Schleifer,68,a banker. She grew up hearing stories about a great-aunt named Maria Panula, 42, who had sailed on the Titanic for America to be reunited with her husband. According to the information Mrs Schleifer had gathered, Panula gave up her seat on a lifeboat to search for her five children----including a 13-month-old boy named Eino--from whom she had become separated during the final minutes of the crossing. "We thought they were all lost in the sea." says Schleifer.
Now, using teeth and bone pieces taken from the baby's grave, scientists have compared the DNA from the Unknown Child with those collected from members of five families who lost relatives on the Titanic and never recovered the bodies. The result of the test points only to one possible person: young Eino. Now the family see no need for a new grave. "he belongs to the people of Halifax," says Schleifer. " They've taken care of him for 90 years."
Adapted from
,November 25 ,2002 [/INST] question: The baby traveled on the Titanic with his _ . | options: A: mother B: parents C: aunt D: relatives | answer: A </s> |
<s>[INST] context: It seems school children all over the world complain about their school food.Cherie Blair,the wife of Prime Minister Tony Blair,said that she would prepare a packed lunch for her son if school dinners do not improve. So what do students of your age eat for lunch at school?
Japan
High schools have canteens,which serve everything from noodles to rice,but not burgers and chips.Other children bring food from home such as cold rice balls,meat or fish,pickles and vegetables.
The United States
A typical menu from a US school is made up of a hamburger with fried potatoes or roast chicken,lettuce and pickles,fruit and cookies.School lunches must also provide at least one-third of the daily dietary
allowances of protein ,vitamin A.vitamin C,iron,calcium,and calories .
Australia
Meat pies,sausage rolls and hotdogs are all traditional dishes in Australian school shops.But as the nation pays more attention to children's health,healthier foods have started to find their way onto school menus.
Many schools have used a traffic light system.The sale of red-labelled foods including pastries,chocolate and soft drinks,is served only twice a week.Healthier green-labelled foods such as sushi,sandwiches,corn and watermelon,however are served every day.
In some schools.students have a choice of up to 89 foods to choose from,including popcorn and rice.
South Africa
Most of South Africa's schools do not serve meals at all.Classes end at 1:30 pm and students get their own lunches.Many students bring food from home,usually sandwiches.
Fast food and fried food sell the best among students,which has led to a rise in obesity among children.But as more people began to realize the fact that being too fat may cause different diseases,some schools in towns have led the way towards better nutrition .Now students at these schools are provided with lunches of porridge with vegetables,such as cabbages,onions,beans,carrots and tomatoes. [/INST] question: Which belongs to red-labelled food in Australia? | options: A: sandwiches B: beer C: tomatoes D: corn | answer: B </s> |
<s>[INST] context: Ernest Hemingway was born in Oak Park, Illinois, on July 21st, 1899. Influenced by his father, he enjoyed camping, fishing and hunting at his early age. In 1917, after graduation from high school, Hemingway began his writing career with The Kansas City Star. And then, after being rejected for army service in World War I because of poor vision, he volunteered to serve as a driver for an American ambulance unit in France. In 1918, he transferred to duty on the Italian front, where he was seriously wounded in an explosion. After his recovery, he returned home. He worked for The Toronto star, covered the Greco-Turkish war as a foreign reporter, and then returned to Paris, which was a city full of intellectual life, creativity, and genius after the war. In Paris, where he accomplished a revolution in literary style and language, his first book, Three Stories and Ten Poems, appeared in 1923, and was followed by a short story collection In Our Time, which marked his entry to American literature in 1925.
Hemingway's status as a remarkable writer of his time was confirmed with the publication of A Farewell to Arms in 1929. The novel represented a farewell both for war and for love. In 1937, he became a foreign reporter covering the Spanish Civil war. Three years later, he published For Whom the Bell Tolls. Set in Spain during the Civil war, the novel restated his view of love found and lost and described the tough spirit of the common people. In 1912, the same judgment was reflected in his portrait of fisherman, Santiago, with an _ spirit in defeat, in The Old Man and the Sea, which was awarded the Pulitzer Prize in 1953. Hemingway won the Nobel Prize in Literature in 1954. With one of the most important influences on the development of the American short story and novel, Hemingway has seized the imagination of the American public like no other twentieth-century author. He died by suicide, in Ketchum, Idaho, in 1961. [/INST] question: Hemingway was turned down for army service in World war I because _ . | options: A: he was unlearned B: he was in poor condition C: he was inexperienced D: he had bad eyesight | answer: D </s> |
<s>[INST] context: Diagnosis in this case is subacute thyroiditis. Symptoms are more severe in acute thyroiditis with complications and acute thyroiditis is more common in children.
Just take a look of acute thyroiditis.
• Acute thyroiditis is rare and due to suppurative infection of the thyroid.
• More common in children and often is preceded by an upper respiratory tract infection or otitis media.
Etiology
The thyroid gland is inherently resistant to infection due to its extensive blood and lymphatic supply, high iodide content, and fibrous capsule.
Infectious Agents can Seed Thyroid
1. Via hematogenous or lymphatic route
2. Via direct spread from persistent pyriform sinus fistulae or thyroglossal duct cysts
3. As a result of penetrating trauma
4. Due to immunosuppression
• Streptococcus and anaerobes account for about 70% of cases.
• In children and young adults, MC cause is presence of a pyriform sinus (remnant of the fourth branchial pouch that connects the oropharynx with thyroid), such sinuses are predominantly left-sided.
• Long-standing goiter and degeneration in thyroid malignancy are risk factors in elderly.
Clinical Features
• Thyroid pain, often referred to the throat or ears, and a small, tender goiter.
• Fever, dysphagia and erythema over the thyroid.
• Systemic symptoms of a febrile illness and lymphadenopathy.
• Complications such as systemic sepsis, tracheal or esophageal rupture, jugular vein thrombosis, laryngeal chondritis, and perichondritis or sympathetic trunk paralysis may also occur.
Diagnosis
• ESR and WBC count are usually increased, but thyroid function is normal.
• FNA biopsy shows infiltration by polymorphonuclear leukocytes.
• Culture of the sample can identify the organism.
• Persistent pyriform sinus fistula should be suspected in children with recurrent acute thyroiditis. A barium swallow demonstrates the anomalous tract with 80% sensitivity.
Treatment
• Parenteral antibiotics and drainage of abscesses.
• Patients with pyriform sinus fistulae require complete resection of the sinus tract, including the area of the thyroid where the tract terminates, to prevent recurrence. [/INST] question: A young patient has a midline, tender swelling in neck occurring after an attack of sore throat. The diagnosis is - | options: A: Acute thyroiditis B: Thyroglossal cyst C: Sub acute thyroiditis D: Toxic goiter | answer: C </s> |
<s>[INST] context: Glucose-6-phosphate dehydrogenase catalyzes the initial step in the hexose monophosphate (HMP) shunt, oxidizing glucose-6-phosphate to 6- phosphogluconolactone and reducing nicotinamide adenine dinucleotide phosphate (NADP) to NADPH. The main function of the HMP shunt is to protect red blood cells against oxidative injury the production of NADPH. Red blood cells contain relatively high concentrations of reduced glutathione (GSH) which is protective against oxidant injury. The oxidants, such as super oxide anion (O2-) and hydrogen peroxide, are formed within red cells due to reactions of hemoglobin with oxygen and due to drugs or infections. They accumulate within red cells and cause oxidation of hemoglobin and other proteins leading to loss of function and cell death. The combined effect of HMP shunt to glutathione metabolism is responsible for protecting intracellular proteins from oxidative stress. G6PD deficiency results in hemolytic episodes related to altered HMP shunt and glutathione metabolism. The cells that over express G6PD are protected against oxidative injury. [/INST] question: Oxidative injury of the red blood cells leading to heamolysis is associated with of the following clinical conditions? | options: A: G6PD deficiency B: Hereditary spherocytosis C: Sickle cell anemia D: Hemophilia | answer: A </s> |
<s>[INST] context: The baby elephant Ishanga was lying in the bushes, scared, starving, and struggling to breathe. Until just a few days before, she had been with her mother, walking through the sweeping grasslands of Tsavo National Park in the African country of Kenya.
The baby's mother was killed, most likely by a poacher. On Wednesday, November 17,2010, an anti-poaching team was removing the deadly wire traps that poachers set throughout the park. Luckily, a member of the team spotted the baby and rushed to help her.
Suddenly, a lion sprang from the bushes and clamped its mouth around her neck. One person managed to pull out his gun and fire shots in the air. The shocked lion released the baby and backed away.
Now the weakened baby had a grave wound on her neck. About 300 miles north of Tsavo is a place that helps baby elephants. Over the years, the orphanage has raised 130 elephants and successfully released them back into the wild.
After a tense wait and a plane ride, the baby's rescuers made it to the orphanage. The medical staff worked frantically to treat her wound. She was scared and wild. She screamed, and wouldn't let any humans get near her, refusing to eat or drink.
After two hours of intense medical care, Ishanga awoke and slowly struggled to her feet. Two keepers and a veterinarian had been with her all night. They were relieved that she seemed to be recovering.
The next day, though Ishanga remained weak, her keepers introduced her to some of the other 14 young elephants living at the orphanage. The keepers stood back as the other elephants extended their trunk in friendly greetings. The older elephants led Ishanga around, giving her a tour of her new home.
Over the past year, Ishanga's wounds have healed. She has made many friends. It'll be up to Ishanga to decide when she's ready to leave the orphanage. Returning to the wild is a long process that can take more than 10 years. For now, she is in no rush to leave this extraordinary community of elephants and humans. Ishanga has a long, happy life ahead of her. [/INST] question: When the baby elephant was saved by the team, she was _ . | options: A: badly ill B: very dangerous C: dead D: badly wounded | answer: D </s> |
<s>[INST] context: As a young man, Tom was a famous artist with a wife and two fine sons. One night, his older son was ill. Tom and his wife thought it was nothing serious. But the boy died suddenly that night..
After his son died, Tom always felt very sad. To make matters worse, his wife also left him later, leaving him alone with his six-year-old younger son, Emie. Sadly, he turned to alcohol for help.
As time went by, Tom began to lose everything he had---his land, house, etc. A few months later, Tom passed away alone in a small bar. Hearing of Tom's death, I thought,"What a complete failure!"
But later, I began to change my earlier opinion. I knew Tom's now adult son, Emie. He is one of the kindest, most caring men. I saw the love between Emie and his children. And I thought that kindness and caring had to come from somewhere.
One day, I asked him what made him become such a specia1 person. Emie said quietly, "My father came into my room every night, give me a kiss and said,"love you, son."
Hearing his words, I understood everything. Tom didn't leave many things behind. But he had been a kind loving father, and left behind his best love. [/INST] question: How many sons did Tom have? | options: A: One B: Two C: Three D: Four | answer: B </s> |
<s>[INST] context: How many historic churches, pubs or buildings are there in your city? Are there worth preserving? Or are they just a waste of space? There are arguments for and against spending money on historic buildings.
Dangerous staircases. Uneven floors. A lack of IT infrastructure. The problem with many old buildings is that they're... old - and extremely expensive to modernize. Take the case of the Combination Room in Cambridge University. It was built in 1347 and was initially used for lectures. Later, it became the Regent House - the university's parliament. It's of enormous historical value and cultural interest. However, it doesn't meet accessibility standards for disabled people. As a result, a lift needs to be installed, but not everyone is happy about this. "Noting will persuade me that this lift would not in its effect, be a substantial alteration to the most precious room in the university. It would destroy the symmetry of that beautiful room," said one user.
In general, modern buildings don't have this type of problem. They can be built according to the latest environment standards, with draught proofing and insulation to help reduce carbon emission and save energy. They can also be made wheelchair accessible, and they can be designed to ensure maximum comfort and space. Anyone who's been to a modern cinema, theatre or concert hall recently may understand the difference between the new buildings and older ones, which tend to have smaller seats, less space and poorer acoustics.
Very often, there's money to be made by knocking down old building... especially if they're in city centers. So, the biggest threat to many historic buildings comes from developers. One of Croydon's oldest pubs, The Rose and Crown, is a perfect example of this. A property development company has recently been granted permission to convert the 18th century building into flats, much to the disappointment of many local residents. "The bar is full of unique features and perfect examples of a traditional London pub. It really would be truly tragic for this Grade II listed building to be turned into soulless flats," said a spokesperson for English heritage.
So, are these buildings really worth preserving? "Traditional buildings such as churches, town halls, schools and hospitals give England its character," the spokesman added. " _ "[(<<>> 20116 "Building Bash")] [/INST] question: _ are not accessible to the Combination Room in Cambridge university without a lift. [ ] | options: A: The old B: The disabled C: The young D: The deaf | answer: B </s> |
<s>[INST] context: Peritonsillar space Quinsy (Peritonsillar abscess) usually unilateral and most commonly affected adult males i) This consists of suppuration outside the tonsillar capsule, and the swelling can extends to the soft palate and the tonsil may also be pushed medially. ii) It is a complication of acute or chronic tonsillitis, There occurs accumulation of pus between the tonsil capsule and tonsil bed. In most cases pus collection occurs antero-superior to tonsil, but may sometimes occur lateral or superior to tonsil iii) Quinsy is the collection of pus in the peritonsillar space which lies between the capsule of tonsil and the superior constrictor muscle Para-pharyngeal labscess-infection from tonsil or peritonsillar tissue may involve parapharyngeal space with abscess formation. The tonsil should be removed 6-8 weeks following a quinsy Complication of peritonsillar abscess Aspiration and asphyxia Para pharyngeal abscess Thrombosis of internal jugular vein or even a carotid aery rupture can occurs because of extension of this abscess to para pharyngeal space Laryngeal oedema with resultant asphyxia Septicaemia and multiple abscesses mayo cure [/INST] question: In which of the following locations there is collection of pus in the quinsy: | options: A: Peritonsillar space B: Parapharyngeal space C: Retropharyngeal space D: Within the tonsil | answer: A </s> |
<s>[INST] context: Down’s syndrome is the most common of the chromosome disorders and a major cause of mental retardation.
Cytogenetic abnormality
Non disjunction (MC) = 95%
Translocation (robertsonian) = 4 %
Mosaicism = 1%
Increased maternal age is the main risk factor .
Translocation carriers carry high recurrence risk.
Clinical features: Cardiac → endocardial cushion defect (MC)
Hypotonia GIT → duodenal atresia, TEF, IHPS, Hirschprung
Mental retardation disease, annular pancreas
Short stature musculoskeletal system → atlantoaxial
Dislocation
Microcephaly/ brachycephaly Respiratory → recurrent aspiration pneumonia
Open AF Endocrine → primary gonadal defect,
Hypothyroidism
Oblique palpebral fissure Haematopoietic → increased ALL and AML
Bushfield spot . But AML has a better
Depressed nasal bridges prognosis than normal individuals
Low set ears CNS Alzheimer's in patients older than 40 years
Short neck
Simian crease, clinodactyly
Sandal gap between 1st and 2nd
Toes
Kennedy crease [/INST] question: The most common chromosomal defect is: | options: A: Down’s B: Turner C: Edward D: Patau | answer: A </s> |
<s>[INST] context: Bicycles for rent could become as common as newspaper stands and mail boxes on prefix = st1 /Germany's street corners if a scheme launched by Deutsche Bahn is successful.
The German rail operator has launched a bicycle-hire scheme designed for simple one-way trips.
"It's a new concept,"said Andreas Knie, head of the project.
Users must first register with Call-A-Bike at a cost of 15 euros(US$14.7). With a simple phone call, they can hire one of the many bikes parked outside stations, at a cost of 3 to 5 cents per minute. At the end of their journey, they ring a computer and tell it where the bike is parked.
The bikes are available 24 hours a day, seven days a week.
No one will be breaking speed records with Call-A-Bike bicycles. They weigh in at 25 kilograms, at least double the weight of a normal bicycle, though they do have eight gears .
"They are pretty heavy, but we don't want people taking them on the train or into the subway," Knie said.
They are also designed with parts that do not fit a normal bicycle. Even the screws are irregular and the bike looks so odd that thieves would stand out.
Vandalism and theft have led to the downfall of previous schemes which date back toAmsterdam's 1966"White Bike"scheme.
In that short-lived experiment, anti-establishment groups painted bikes white and left them around the Dutch capital.
However, many were taken permanently and repainted, while the police took away others on the basis that ownerless bikes were street rubbish.
Copenhagen, Vienna and Helsinki also have free bike schemes, in which users deposit a coin in Copenhagen's case 20 crowns(US$2.50)--to free a bike from a rack.
"The advantage these schemes have is ease of use. But because they're so cheap, people tend to hold on to the bikes and then there are none on the streets,"the person in charge said.
Oslo is also planning a bike-hire system where users will pay a symbolic fee of 50 Norwegian crowns(US$6.50)for unlimited use in the city for a year.
Users will buy an electronic identity card as a key that will register when the bike is parked or taken from a rack. [/INST] question: How many European countries have already launched the free bike schemes? | options: A: Four B: Five C: Six D: Seven | answer: B </s> |
<s>[INST] context: Give people a chance before you judge them because you really never know what's going on beneath the surface. I am always reminded that judging a person by what others say or my first impression is usually wrong.
It's so easy to make assumptions and expectations about someone, just to find out they were completely false. The shy girl turns out to be one of the funniest girls I've ever met; the mean girl is actually very sensitive and loving; the _ guy is unsure of himself, etc.
I hope there is a world where we stop judging a person by what they wear, their hairstyle, their job, their car; we simply love and accept them for who they are. Someone may have untidy hair because they over slept, or their clothes don't match because their house burned down and lost everything. All I'm saying is, "can we focus more on what's going on inside a person rather than the outside?"
There are so many people who seem like everything is just fine on the outside, but the inside is angry or hurting. They don't know how to just be themselves or they're afraid to because they may be seen as the "crazy" or "strange" persons.
I truly believe everything begins with ourselves. Before we can really stop judging others by the outside, we must stop judging ourselves. We must know how to treat ourselves first. Let's stop getting in our own way and accept ourselves and others as we are. [/INST] question: When we judge a person, we should pay more attention to _ . | options: A: what he wears B: what he does or has C: our first feelings and thoughts D: what's going on inside him | answer: D </s> |
<s>[INST] context: (C8, T1) (53-BDC-l 4th)ERB'S PARALYSISKLUMPKE'S PARALYSISSite of Injury - The region of the upper trunk of the brachial plexus is called Erb's point, six nerves meet here. Injury to the upper trunk causes Erb's paralysis.Lower trunk of brachial plexusCause of injury - Undue seperation of the head from the shoulder, which is commonly encountered in (i) birth injury (ii) fall on the shoulder (iii) during anaesthesiaUndue abduction of the arm, as in clutching something with the hands after a fall from a height or sometimes in birth injuryNerve root involved - Mainly C5 and partly C6Mainly T1 and partly C8Muscle paralysed - Mainly biceps, deltoid, brachialis, and brachioradialis. Partly supraspinatus, infraspinatus and supinatorDeformity - (position of the limb)Arm: Hangs by the side: It is adducted and medially rotated.Forearm: Extended and pronatedThe deformity is known as "policeman's tip" or "porter *s tip hand'1. Intrinsic muscles of the hand (Tl)2. Ulnar flexors of the wrist and fingers (C8)Claw hand* due to the unopposed action of the longflexors and extensors of the fingers.(Hyperextension at the MCP joint and flexion at the IP joint)Disability: The following movements are lost1. Abduction and lateral rotation of the arm (shoulder)2. Flexion and supination of the forearm3. Biceps and supinator of the forearm4. Sensation are lost over a small area over the lower part of the deltoid1. Claw hand2. Cutaneous anaesthesia and analgesia in a narrow zone along the ulnar border of the forearm and hand3. Homer's syndrome (This is because of injury to sympathetic fibres to the head and neck that leave the spinal cord through nerve T14. Vasomotor changes5. Trophic changes [/INST] question: Klumpke's paralysis involved | options: A: C5, 6 B: C6, 7 C: C7, 8 D: C8, T1 | answer: D </s> |
<s>[INST] context: (ECTA) (41 7-Reddy 29th) (2.38, 7.7-Parikh 6th)DNA-FINGER PRINTINGIdentification of person by genetic analysis*** DNA is extacted from the nuclei of white blood cells or of spermatozones or of the hair follicles cells that cling to the roots of hair that have fallen, or been pulled.* DNA finger printing is based on variable number Tandem repeats (VNTR) and short tandom repeats (STR)*** The fragments are separated according to size by gel electrophorasis*** DNA finger printing was founded by A.Jeffrey** (1985)* Currently the most important tool used to make a paternity determination is a blood test called a human leucocyte antigen (HLA) test*** Sample of DNA testing must Contain nucleated cells ig leuocytes, seminal fluid, brain, bone marrow, muscle skin, dental pulp, hair with root sheeth cells, and dried stains.Liquid blood - in case of paternity, maternity disputes, biological relationship-2-5 ml- blood is collected in sterile leakproof preferably screw - capped tubes containing heparin or EDTA as anticoagulant. EDTA extracts metallic ions, prevents clotting inhibiting enzymes in blood or micro organisms which may breakdown DNA during storageThe sample should reach the laboratory within 24 to 48 hours* Visceral samples sends in Normal saline or 20% solution of dimethyl sulphoxide (DMSO) saturated with sodium chloride * Preservative used for toxicological specimen - saturated sodium chloride* Sodium fluoride is used for preservation of - Alcohol* In all cases of poisoning inclusive of carbolic acid but exclusive of other acids saturated solution of common salt should be used* In cases where poisoning by acids is suspected except(i) Carbolic acid (phenol) (ii) Alcohol (iii) Acetic acid (iv) phosphorus (v) paraldehyde, rectified sprit should be used*** Temporary modification or obliteration of ridge pattern may be seen in variety of other conditions such asIncomplets Ridge atrophyRidge alterationIncreased distance between Ridge with preserved pattern* Dermatitis* Eczema* Infantile paralysis* Celiac disease* Acanthosis nigricans* Rickets * Scleroderma* Acromegaly * Dry / atrophic skin * Permanent impairment ot the linger print pattern occours in - leprosy, electric injury and after exposure to radiation**IMPORTANT POINTS1. Uric crystal (Gouty tophus) would be submitted to the pathology laboratoryin Alcohol**2. Preservation of brain is NOT required in - Heavy metal poisoning** (Bone)3. Finger print Bureau was first established in India (Calcutta in 1897)4. In autopsy, preservative used for vitreous is - Fluoride fluoride is added to vitreous as preservative if alcohol estimation is required and also for analysis of cocaine, cyanide , and Co-poisoning5. Virological examination of autopsy specimen - sample freazed or preserved in 80 glycerol in buffered saline6. Brain finger printing - is a technique that measure recognition of familiar stimuli by measuring electrical responses to words, phrases or pictures that are presented on a computer screen.Brain finger printing uses electrical brain responses to detect the presence or absence of information stored in brain 7. Polygraph (lie-detector)- which measures emotion- based physiological signals such as heart rate, sweating and blood pressure1 [/INST] question: Blood sampling in DNA profiling stored in | options: A: EDTA B: Sodium fluoride C: Sodium fluoride + Oxalates D: Sodium chloride | answer: A </s> |
<s>[INST] context: Gold Coast theme parks come in all shapes and sizes and whether you like roller coasters or patting furry animals, you're sure to find something.
Movie World
Movie World is the only movie-related theme park in Australia. With one of the best coasts and a good handful of movie-related rides, you'll experience a fun-filled adventure with the glamour of Hollywood. Get "behind the scenes" movie information and stunt shows to keep the whole family entertained for the best part of a day.
Contact Information:
Phone: 07--5573--8485
Address: Pacific Motorway, Oxenford, Queensland 4210
Website: www. movieworld.com.au
Sea World
With an obvious emphasis on things that live in the water, Sea World has a fantastic range of fish, sharks, dolphins, seals, polar bears and other assorted animals in the water. Throw in a bunch of great rides, water slides and roller coasters, and Sea World emerges as perhaps the best all-round theme park on the Gold Coast.
Contact information:
Phone: 07--5588--2222
Address: Sea World Drive, Main Beach, Queensland 42
Website: www. seaworld. com.au
Tropical Fruit World
Home of the world's largest varieties of bizarre, and wonderful fruits, or you can pay to check out the plantation safaris , mini-train rides, jungle cruises and fruit tasting shows. Admission is about $32 for adults and %15 for kids and free for kids under 5.anbah Road, Duran
Contact Information:
Phone: 02--6677--7222
Address: Duranbah Road, Duranbah, NSW 2487
Website: www. tropicalfruitworld. com. au
Currumbin Wildlife Sanctuary
Crocodiles, kangaroos, koala and almost all of the other famous Australian native animals are living in Currumbin Wildlife Sanctuary. You can look at them, feel and pat some of them or just experience the fantastic 27 hectare bush land setting--an oasis of wildlife amidst the Gold Coast bustle.
Contact Information:
Phone: 07--5534--1266
Address: 28 Tomewin Street Currumbin, Queensland 4223
Website: www. currumbin. sanctuary. org. au [/INST] question: If you want to watch stunt shows, you can go to _ . | options: A: Movie World B: Sea World C: Tropical Fruit World D: Currumbin Wildlife Sanctuary | answer: A </s> |
<s>[INST] context: Clindamycin: This potent lincosamide antibiotic is similar in mechanism of action (inhibits protein synthesis by binding to 50S ribosome) and spectrum of activity to erythromycin with which it exhibits paial cross resistance. Modification of the ribosomal binding site by constitutive methylase enzyme confirs resistance to both. It inhibits most gram-positive cocci (including penicillinase producing Staph., but not MRSA), C. diphtheriae, Nocardia, Actinomyces, Toxoplasma, but the distinctive feature is its high activity against a variety of anaerobes, especially Bact. fragilis. Aerobic gram-negative bacilli, spirochetes, Chlamydia, Mycoplasma and Rickettsia are not affected. Side effects are rashes, uicaria, abdominal pain, but the major problem is diarrhoea and pseudomembranous enterocolitis due to Clostridium difficile superinfection which is potentially fatal. The drug should be promptly stopped and metronidazole (alternatively vancomycin) given to treat it. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:731 [/INST] question: Drug-induced colitis is most frequently associated with | options: A: Neomycin B: Vancomycin C: Clindamycin D: Chloramphenicol | answer: C </s> |
<s>[INST] context: Bob is a middle school student. He is 13years old. He lives in Shanghai with his parents and his twin brother, Jack. They are in the same( ) school, but in different classes. Bob is good at Maths, but not good at English. He thinks it's a little difficult for him. But he plans to spend more time on it.
Every morning, Bob gets up early. He usually reads English for half an hour. And then he has breakfast with his family. He usually has two eggs and a glass of milk. After breakfast, he walks to school with his brother. It takes them about twenty minutes to get to school. They get to school at about 7:40.
Bob begins his classes at 8:00. After four lessons in the morning, he has a hamburger, some fish and vegetables for lunch at school. Then he has three classes in the afternoon. His last class is over at 4:50p.m. After school, he usually plays football or basketball from 5:00 p. m. to 6:00 p.m. He says it is good for his health to play sports every day.
He gets home at 6:20 p.m. He usually eats some rice and vegetables for dinner. Sometimes, he eats some noodles. After dinner, he does his homework from 7:30to 9:30. Then he listens to music or reads books for a while( ). He doesn't watch TV or play computer games on weekdays. He goes to bed at 10:30 p.m.
His friends say his lifestyle is very healthy. Do you think so? [/INST] question: Bob thinks _ is a little difficult for him. | options: A: English B: Geography C: Maths D: History | answer: A </s> |
<s>[INST] context: Summer holiday is coming , what do you like to do ?here are four students telling us what they will do in the coming summer holiday.
Mai hajui Baihetiya, 14 .
I am from Xinjiang . I am studying at Tianjin No.2 Middle School now. I will go on a trip to Beijing . I am going to the Great Wall , the Summer Palace and the Palace Museum . I will go to Wangfujing Street to buy a sweater for my mother, a scarf for my father and a T- shirt for my brother.
Wu Jun, 13.
I come from Shanghai . My favourite season is summer . I like going swimming with my friends in the swimming pool. It is very exciting .
Mike ,13 .
I am studying at Nanjing No. 5 Middle School . I miss my parents very much . I will go back to America to see my family . Summer is a good season to go out . I will have a picnic with my friends in the countryside . I can also play football and baseball with my friends . How happy we will be .
Liu Shuyi, 14,
I am from Shanghai . I like summer best because I can eat ice cream and wear a dress. I am not good at English . I will join an English club to learn English . [/INST] question: How many family members will Mai hajui Baihetiya buy presents for? _ | options: A: Three B: Four C: Five D: Six | answer: A </s> |
<s>[INST] context: C- Mucous membrane and circular smooth muscle layer of rectum form three transverse folds; middle one is called Houston's valve. Venous blood returns to poal venous system the superior rectal vein. A -In females, the urethra extends from bladder, runs above anterior vaginal wall, and pierces the urogenital diaphragm to reach urethral orifice in the vestibule behind the clitoris. It is about 4 cm long. In males, the urethra is about 20 cm long. B. - Obturator internus muscle and its fascia form lateral wall of ischiorectal fossa. This muscle is innervated by nerve to obturator internus, which passes through greater and lesser sciatic foramen. D. -Vagina is the genital canal in the female, extending from vestibule to uterine cervix. It transmits the products of menstruation and receives penis in copulation. E.- Ischiorectal fossa lies in anal triangle and is bound laterally by obturator internus with its fascia and superomedially by levator ani and external anal sphincter. It contains inferior rectal vessels. Thus, haemorrhage occurs in ischiorectal fossa when it is ruptured. [/INST] question: CT scan of female perineum and pelvis is given below. Which structure has Houston's valve or fold, with its venous blood drained by poal venous system? | options: A: B B: C C: A D: E | answer: B </s> |
<s>[INST] context: It seems school children all over the world are not satisfied with their school food. Cherie Blair, the wife of Prime Minister Tony Blair, said that she would prepare a packed lunch for her son if school dinners do not improve. So what do students of your age eat for lunch at school?
Japan
High schools have dining halls, which serve everything from noodles to rice, but not hamburgers and chips. Other children bring food from home such as cold rice balls, meat or fish, and vegetables.
The United States
A common menu from a US school is made up of a hamburger with fried potatoes or roast chicken, fruit and cookies. School lunches must also provide food with protein ,vitamin A, vitamin C, ironand calories.
Australia
Meat piesand hotdogs are all traditional dishes in Australian school shops. But as the nation pays more attention to children's health, healthier foods have started to find their way onto school menus.
Many schools have used a traffic light system. The sale of red-labeled foods includingchocolate and soft drinks, is served only twice a week. Healthier green-labeled foods such as sandwiches, corn and watermelon, however are served every day.
In some schools, students have a choice of up to 89 foods to choose from, including popcorn and rice.
South Africa
Most of South Africa's schools do not serve meals at all. Classes end at 1:30 pm and students get their own lunches. Many students bring food from home, usually sandwiches.
Fast food and fried food sell the best among students, which has led to a rise in _ among children. But as more people began to realize the fact that being too fat may cause different illnesses, some schools in towns have led the way towards better nutrition . Now students at these schools are provided with lunches of porridge with vegetables, such as cabbages, carrots and tomatoes. [/INST] question: Which belongs to red-labeled food in Australia? | options: A: sandwiches B: apple juice C: tomatoes D: corn | answer: B </s> |
<s>[INST] context: Because of the increase in multi-drug-resistant strains of gram-positive bacteria, the development of new and novel-acting antimicrobial agents is at the forefront of pharmaceutical research. Currently, the prevalence of methicillin-resistant staphylococci (MRSA) and vancomycin-resistant enterococci (VRE) is a major clinical problem. Linezolid (Zyvox(r)-Pfizer) is an antimicrobial agent of the oxazolidinone class that possesses a wide spectrum of activity against gram-positive organisms, including MRSA and VRE. Because of linezolid's novel mechanism of action, cross-resistance with other antimicrobial agents is not expected. Linezolid is therefore a ble option for ceain types of infectious disease. Linezolid should not be used for empiric therapy, except under unusual circumstances, or to treat mild gram-positive infections where other antimicrobial agents would be effective. Thrombocytopenia has been repoed in patients treated with linezolid. Platelet levels in most patients returned to normal during the follow-up period. The risk of thrombocytopenia appears to be related to duration of therapy. Platelet counts should be monitored at baseline and at least every 7 days during treatment. [/INST] question: Which of the following should be monitored if linezolid is given for more than 14 days? | options: A: Liver function tests B: Kidney function test C: Platelet count D: Audiometry | answer: C </s> |
<s>[INST] context: Tuberous sclerosis complex (TSC) is a rare multisystem genetic disease that causes benign tumors to grow in the brain and on other vital organs such as the kidneys, hea, liver, eyes, lungs, and skin. A combination of symptoms may include seizures, intellectual disability, developmental delay, behavioral problems, skin abnormalities, and lung and kidney disease. TSC is caused by a mutation of either of two genes, TSC1 and TSC2, which code for the proteins hamain and tuberin, respectively. These proteins act as tumor growth suppressors, agents that regulate cell proliferation and differentiationTSC is a genetic disorder with an autosomal dominant pattern of inheritance, variable expressivity, and complete penetrance. Two-thirds of TSC cases result from sporadic genetic mutations, not inheritance, but their offspring may inherit it from them. Current genetic tests have difficulty locating the mutation in roughly 20% of individuals diagnosed with the disease. So far, it has been mapped to two genetic loci, TSC1 and TSC2. [/INST] question: Type of inheritance in Tuberous sclerosis | options: A: Autosomal dominant B: Autosomal recessive C: X-linked dominant D: X-linked recessive | answer: A </s> |
<s>[INST] context: Exchange a glance with someone, and then look away. Do you realize that you have made a statement? Hold the glance for a second longer and you have made a different situation, there is a permissible time that you can hold a person's stare without being friendly, rude, or aggressive. If you are on a lift, what stare-time are you permitted? To answer this question, consider what you typically do. You very likely give other passengers a quick glance to size them up and to assure them that you mean no harm. Since being close to another person signals the possibility of interaction, you need to send out a signal telling others you want to be left alone. So you cut off eye contact----what sociologist Erving Goffiman calls "a dimming of the lights". You look down at the floor, at the indicator lights, anywhere but into another passenger's eyes. Should you break the rule against staring at a stranger on a lift, you will make the other person extremely uncomfortable, and you are likely to feel a bit strange yourself.
If you hold eye contact for more than 3 seconds, what are you telling another person? Much depends on the person and the situation. For instance, a man and a woman communicate interest in this manner. They stare at each other for about 3 seconds at a time, and then drop their eyes down for 3 seconds, before letting their eyes meet again. But if one man gives another man a 3-second-plus stare, he signals, "I know you", "I am interested in you" or "You look peculiar and I am curious about you". This type of stare often produces hostile feelings. [/INST] question: If one is looked at by a stranger for too long, he tends to feel _ . | options: A: depressed B: uneasy C: curious D: amused | answer: B </s> |
<s>[INST] context: In Anorexia nervosa, the severe reduction in GnRH pulsatility leads to suppression of FSH and LH secretion, possibly to undetectable levels, and results in anovulation and low serum estradiol levels. Given the severe psychologic and metabolic stress experienced by these individuals, the hypothalamic-pituitary-adrenal axis is activated. The circadian rhythm of adrenal secretion is maintained, but both coisol production and plasma coisol levels are persistently elevated secondary to increased pituitary secretion of adrenocoicotropic hormone (ACTH). Serum leptin levels in these individuals are significantly lower than normal healthy controls and correlate with the percentage of body fat and body weight. A rise in leptin levels in response to dietary treatment is associated with a subsequent rise in gonadotropin levels.""Inhibition of reproduction function-- Enhanced release of the coicotrophin-releasing hormone (CRH) and b-endorphin suppresses GnRH release directly and indirectly through the release of glucocoicoids. Elevated glucocoicoids suppress the release of GnRH, luteinizing hormone, and follicle-stimulating hormone, and produce gonadotropin resistance at the gonads. This suppression in gonadal function is evident in patients with anorexia nervosa and extreme athletes." [/INST] question: A 22-year-old female came with the chief complaint of significant weight loss and secondary amenorrhea. She has a high-intensity exercise regimen, is preoccupied with food, and seems to have an irrational fear of gaining weight. Decreased production of which of the following hormones leads to amenorrhea in anorexia nervosa? | options: A: Gonadotropin releasing hormone (GnRH) B: Progesterone C: Human chorionic gonadotropin (hCG) D: Estradiol | answer: A </s> |
<s>[INST] context: Friendship Restaurant
We have different kinds of Japanese food here. The food menu is in Japanese and Chinese. All the waiters and waitresses can speak at least one foreign language.
Tel: 312-9997
Time: 11:30 a.m.-10:00 p.m.
Volunteer Project
Maybe you want to help others but don't know how to do it. Then Volunteer Project will help you. Here you will get the best idea of volunteering.
Call 822-5566 to join it.
E-mail address:[email protected]
Dream corner
Do you want to improve your English? Do you want to practice your English with native speakers? If yes, why not join the Dream Corner? Come here on Friday afternoon every week.
Red Bird club
Do you like dance? Do you want to show off your cool dance at parties? Join us and make your dream come true.
Closed on Tuesday.
Call 822-3331 for more information.
The Underwater World
Here you will find different kinds of fishes and even some kinds of sharks. You will feel you are in the sea but of course this is not true. If you like fishes, I suggest that you pay a visit to it.
Tel: 846-3809
Time: 9:30 a.m. - 5:00 p.m.
,. [/INST] question: You can eat _ food in the Friendship Restaurant. | options: A: English B: Japanese C: French D: Chinese | answer: B </s> |
<s>[INST] context: (Between the innermost intercostal and internal intercostal muscle) (208-BDC-l 4th) (57-Snell 7th)* Each intercostal space contains a large single posterior intercostal artery and two small anterior intercostal arteries.* The corresponding posterior intercostal vein drain backward into the azygos or hemiazygos vein and the anterior intercostal vein drain forward into the internal thoracic and musculophrenic veinsIntercostal nerves* The intercostal nerves are the anterior rami of the first 11 thoracic spinal nerves. The anterior ramus of the 12th thoracic nerve lies in the abdomen and runs forward in the abdominal wall as the subcostal nerve* In the costal groove the nerve lies below the posterior intercostal vessels. The relationship of structures in the costal groove from above downwards is vein-artery-nerve (VAN)*** Each intercostal nerve enters an intercostal space between the parietal pleura and the posterior intercostal membrane. It then runs forward inferiorly to the intercostal vessels in the subcostal groove of the corresponding rib, between the innermost intercostal and internal intercostal muscle [/INST] question: Intercostal vessels and nerve runs in: | options: A: Upper border of the ribs B: External intercostal and Internal intercostal muscle C: Between the external intercostal and innermost internal, inter costal muscle D: Between the innermost intercostal and internal intercostal muscle | answer: D </s> |
<s>[INST] context: You may feel curious about students in other countries: Do they also have so much homework? What do they do in their free time?
On April 8, a report came out on the life of high school students in China, Japan, South Korea and the US. It surveyed around 6,200 students from the four countries last year. You will find the answers to many of your questions in this report.
Who studies hardest?
Chinese students spend the most time studying. Nearly half of Chinese students spend more than two hours on their homework every day. That's much more than students of the US(26.4%), Japan(8.2%) and South Korea(5.2%).
Who sleeps most often in class?
Japanese students fall asleep in class most often. About 45% of them said they sometimes doze off in class. In South Korea is 32%; in the US, 21%; and 5% in China.
South Korean students don't like taking notes. About 70% said they write down what the teacher says in class, many fewer than in Japan(93%), China(90%) and the US (89%).
Who is the most distracted ?
American students are the most active in class, but also the most distracted: 64.2% said they talk with friends in class; 46.9% said they eat snacks in class; and 38.9% said they send e-mails or read unrelated books in class.
What do they do after school?
In their free time, most Chinese students study or surf the Internet. Most American students go out with their friends. Most Japanese students do physical exercises. Most South Korean students watch TV. [/INST] question: In the report, who studies hardest? | options: A: Japanese students B: Chinese students C: American students D: South Korean students | answer: B </s> |
<s>[INST] context: The city of Vienna has always been popular for its famous physicians. Around the year 1482 one such well-known physician was Dr. Paul Urssenbeck. His fame came from his ability to predict with certainty whether a patient would recover his or her health or would die. He thus became known as the doctor of death.
In his earlier years, he followed the trade of a poor but honest weaver in the town of Deckendorf near Straudigen in Bavaria. It was a time of famine , and he, his wife, and their eleven children were in great need. Then a twelfth child was born, and they could find no one to serve as its godparent. As a last chance, the poor weaver walked to a nearby village and asked an old friend to serve as godfather, but met only rejection. Disappointed and frustrated, the poor man made his way back to his family. While walking sorrowfully through the dense forest toward his home, he said, "If only I could die." Suddenly a tall figure dressed in a dark cloak appeared before him, saying, "You called me. I am Death. What can I do for you?" As much as the man had previously wanted to die, he now wanted to live. "I am seeking a godfather for my youngest child. But I cannot find anyone who will serve as his godparent," answered the weaver sadly. "I will accept this responsibility," said Death. And thus it happened.
Following the baptism , the mysterious godfather took the father aside and said, "Since I own neither gold nor silver to give to your child as a baptism present, I will make you into the most famous doctor of all times. Whenever you are called to a sick person, I--invisible to others--will seat myself either to the head or to the feet of the patient. If I am seated at the head, then this will show you that hope for recovery exists. If I am seated at the feet, then the patient will die." Through this gift, the weaver was able to cure many illnesses, for he knew whether the patient who had sought his treatment would be helped by medications, or whether he would die. Soon the previously poor weaver became a wealthy and respected physician. However, his increased wealth made him ever-more greedy.
One day, a very wealthy man fell seriously ill, but when Dr. Urssenbeck was called in, and he saw that Death was already seated at the patient's feet. Upon hearing the diagnosis, the relatives could not be comforted, and they offered the physician a fortune if he could heal the man. Then Urssenbeck _ trickery. He quickly had the patient's bed turned around, so that Death was now seated at his head. Thus the man was rescued from Death, and he regained his health. On the physician's way home, Death suddenly appeared before him. "You unfortunate one, why have you deceived me? In return for the life that you have given back to the rich man, you yourself must now die." Death spoke with a threatening voice, and disappeared.
Dr. Urssenbeck suddenly found himself in a large room where thousands of candles were burning. Death said to him, "Each of these candles represents someone's life. This tiny stump that is about to go out is yours." Terrified, Dr. Urssenbeck reached for a taller candle, wanting to take some wax from it to fill his stump, but in doing so he touched his own candle, and it went out, and he fell to the floor dead. That evening his body was found in a valley. He was buried in the graveyard of Saint Stephen's Cathedral. [/INST] question: Why did Death make the weaver a famous doctor? | options: A: Because he wanted to play a trick on him B: Because he didn't have any baptism gift for his child C: Because he wanted to give him something as a reward D: Because he wanted to show his sympathy to the weaver | answer: B </s> |
<s>[INST] context: Children all over the world like to celebrate their birthdays. American children are the same. They usually celebrate with a party .They ask their friends to their parties. They don't have the party on the right date of their birthday if it comes on a school day. They may hold it at the weekend then.
Today many children like two kinds of parties. One is at home. Parents decorate the house with balloons and coloured paper. They make a special birthday dinner. The children play games. The other kind is away from home. Some are at a special restaurant. The children eat pizza and ice cream. The waiters also sing and say "happy birthday" to the children. Other parties are at a park, or at a cinema, or in some other places.
There is a cake with candles at every birthday party. There is one candle for each year of a birthday boy's or girl's age. When the candles are lighted , everyone sings the special birthday song: HAPPY BIRTHDAY TO YOU.
Birthday parties change. Many people don't have them when they are not young. They say they would like to forget how old they are. But they do like to keep the happy birthday parties of their childhood in mind. [/INST] question: How many kinds of birthday parties are there in America? | options: A: Only one B: Two C: Three D: Four | answer: B </s> |
<s>[INST] context: Rivers are one of our most important natural resources . Many of the world's great cities are located on rivers, and almost every country has at least one river running through it that plays an important part in the lives of its people.
Since the beginning of history, people have used rivers for transportation. The longest one in the United States is the Mississippi. The lifeline of Egypt is the Nile. To the people of India, the Ganges is great, but it is also important for transportation; ships can travel along it for a thousand miles. Other great rivers are the Congo in Africa and the Mekong in southeastern Asia. The greatest of all for navigation , however, is the Amazon in Brazil . It is so wide and so deep that large ships can go about two thousand miles up it.
Besides transportation, rivers give food to eat, water to drink, water for crops, and chances for fun. In order to increase the supply of water for crops, engineers sometimes build a dam across a river and let a lake form behind the dam. Then people can use the water not only to irrigate their fields but also to make electricity for their homes and industries.
However, large cities and industries that are located on rivers often cause problems. As the cities grow in size and industries increase in number, the water in the rivers becomes polluted with chemicals and other materials. People are learning the importance, however, of doing more to keep their rivers clean if they want to enjoy the benefits of these natural resources. [/INST] question: The greatest river for navigation is _ . | options: A: the Mississippi B: the Nile C: the Mekong D: the Amazon | answer: D </s> |
<s>[INST] context: You may have heard adults say they are uncomfortable in the morning without a cup of coffee. One reason they may feel that way is that coffee contains caffeine . Caffeine occurs naturally in coffee, tea, and cocoa beans, which are used to make chocolate. But now food makers are adding it to many products, from potato chips to water.
The US government is especially worried about the problem. That's why the Food and Drug Administration (FDA) is studying the health effects of caffeine on young people. Studies show that too much caffeine can make people nervous and unable to sleep. What's more, caffeine is habit-forming. Those who consume it regularly and stop suddenly may experience headaches and feel tired.
One of the biggest concerns is the large amount of caffeine added to so-called energy drinks, like Red Bull. A 12-ounce can of cola has about 35 milligrams of caffeine. A similar serving of Red Bull contains more than three times that amount.
The Institute of Medicine is also working on caffeine-safety measures. "Teenagers should not drink beverages that contain caffeine. They should be aware of caffeine's effects on health and on how the brain works. Take, for example, teenagers who consume caffeine to stay awake and study for a test. They will remember less of what they just studied," said Stallings, a member of the institute.
Companies that make products with added caffeine claim they do not advertise them to kids. However, there is no law to stop children from buying them. So the FDA needs to set limits on caffeine, especially in energy drinks. As for added caffeine in foods, the government should just say no. If not, the amount of caffeine should be printed on food labels to remind consumers. The government must do that.
Doctors say kids should avoid caffeine. If you need extra energy, try these natural boosters: eat right, exercise, and get plenty of sleep. [/INST] question: What is the US government particularly concerned about? | options: A: The fact that coffee contains caffeine B: The measures of avoiding caffeine's effects C: The practice of adding caffeine to foods D: The practice of using caffeine to make chocolate | answer: C </s> |
<s>[INST] context: Sodium channels are membrane bound proteins that are composed of one large and subunit through which Na ions pass, and one or two smaller b subunits. Voltage - gated Na channels exist in three stages - resting, open and inactivated local anesthetics bind a specific region of the & subunit and inhibit voltage - gated Na channels preventing channel activation and Na influx associated with membrane depolarization. Main mechanism of action of local anesthetics is through inhibition ofActivated, voltage-gated Na channel. Local anesthetics have a greater affinity for the channel in the open or inactivated state than in the resting state. Local anesthetic binding to open or inactivated channels, or both, is facilitated by depolarization. The fraction of Na channels that have bound a local anesthetic increases with frequent depolarization (eg, during trains of impulses).This phenomenon is termed use-dependent block Local anesthetic inhibition is both voltage and frequency dependent, and is greater when nerve fibers are firing rapidly than with infrequent depolarizations Sodium passess through voltage gated sodium channel and cause change in membrane potential and cause depolarization. Local anesthetic attaches to sodium channel and prevents propogation & depolarization [/INST] question: What is the mode of action of local anesthetics? | options: A: Prevents Na+ channel activation and the Na+ influx associated with membrane depolarization B: Change the voltage gated Na+ channel from conducting to non conducting C: Destroys the Na+ channel D: Close the Na+ channel | answer: A </s> |
<s>[INST] context: Not so long ago, a sailor sailing across the cold waters of the northern Pacific Ocean might have had every chance of being confronted by a sea cow. This cow would have measured 10 meters long, and weighed between five and ten tones. And it would spend most of its day cruising the seas, eating grass growing underwater. The cow in question was known as Steller's sea cow, which is now extinct.
Today, many people are unaware that such an extraordinary creature once existed, or don't know its incredible story. But scientists have discovered many fundamental facts about this mystical animal.
Surprisingly, the first recorded sighting of a Steller's sea cow didn't happen until 1741, when a sailing expedition was stuck on an uninhabited island, later named Bering Island. The sailor survived by hunting and eating the huge sea cow. Like its modern relatives, the sea cow lived in herds. _ and its slow-moving behaviour made it easy to be caught.
Those sailors that escaped Bering Island spread word of the bounty of meat to be found off its shores. As a result, more and more expeditions came to hunt the animals. One report stated that one sea cow could feed 33 men for a month.
Incredibly, just 27 years after the island and species had been discovered by modern man, the last sea cow was reported killed. That makes the Steller's sea cow one of the few truly large mammals known to have been driven extinct in the modern age. [/INST] question: Which of the following words can be used to describe the Steller's sea cow? | options: A: Huge B: Fierce C: Aggressive D: Mild | answer: A </s> |
<s>[INST] context: It was late on a snowing night. Doctor Van was driving fast to the hospital to do an operation on a badly hurt person. Minutes later he came to a red traffic light and had to stop to wait. A man suddenly opened the door of the car and got in.
"Drive on, " shouted the man, "Just do what I've told you to. " The man was strong and tall while Doctor Van was not.
"But I'm a doctor, " Van tried to tell him what he was going to do. "I'm on my way to the hospital to save..." "Stop talking and drive faster, as fast as you can!" the man stopped Van and Van had to do so.
Only a few minutes had passed when the man made Van stop his car again and drove him off, and he himself drove away very quickly.
Van stood in the snow for a moment and then walked around to look for a taxi.
Another half an hour had passed when Van got out of the taxi and ran into the hospital. But it was too late and nothing could be done.
The man who had taken Van's car was standing by the person all the time. He was so sad! Only then did Van know that the man was the father of that badly hurt person! [/INST] question: What was the weather like that night? | options: A: Rainy B: Snowy C: Windy D: Warm | answer: B </s> |
<s>[INST] context: Japan is made up of a chain of islands that lie off the coast of Asia. People came to live in Japan from the nearby countries of China and Korea. From these older countries, the Japanese borrowed ideas, inventions and habits.
For many years, the Japanese built houses like those in China. They dressed themselves like a Chinese. From China came their way of writing and their habit of drinking tea.
In more recent times, the Japanese have borrowed things from our country, the United States. They have a government like ours. They do much work in science, as we do. Baseball is a favorite sport in Japan, just as it is here.
Things change when they come to Japan. The Japanese improve on almost everything they borrow. The art of garden making came from Korea and China, but the Japanese gardens are special. Each garden has a waterfall, a pond, and small bridges. There are few flowers in Japanese gardens. But the gardens are green during all the year round because they have many evergreens. Japanese gardens have a different kind of beauty. [/INST] question: Why did the Japanese change the things they had borrowed? | options: A: They wanted very much to be different from others B: They didn't like them the way they were C: They wanted visitors to like the change D: They tried to make them better | answer: D </s> |
<s>[INST] context: Community-acquired acute pneumonia refers to lung infection in otherwise healthy individuals that is acquired from the normal environment. Streptococcus pneumonia Haemophilus influenza Staphylococcus aureus aka pneumococcus, is the most common cause of community-acquired acute pneumonia. Examination of Gram-stained sputum is an impoant step in the diagnosis of acute pneumonia The presence of numerous neutrophils containing the typical gram-positive, lancet-shaped diplococci suppos the diagnosis of pneumococcal pneumonia. It is a pleomorphic, gram-negative organism that occurs in encapsulated and nonencapsulated forms There are six serotypes of the encapsulated form (types a to f), of which type b is the most virulent. H. influenzae pneumonia, which may follow a viral respiratory infection, is a pediatric emergency and has a high moality rate It is an impoant cause of secondary bacterial pneumonia in children and healthy adults following viral respiratory illnesses. high incidence of complications, such as lung abscess and empyema [/INST] question: Most common causative organism of community-acquired acute pneumonia is: | options: A: Staphylococcus aureus B: Streptococcus pyogenes C: Streptococcus pneumoniae D: Haemophilus influenza | answer: C </s> |
<s>[INST] context: The Internet will open up new vistas , create the global village----you can make new friends all around the world. That, at least, is what it promised us. The difficulty is that it did not take the human mind into account. The reality is that we cannot keep relationships with more than a limited number of people. No matter how hard the Internet tries to put you in communication, its best efforts will be defeated by your mind.
The problem is twofold . First, there is a limit on the number of people we can hold in mind and have a meaningful relationship with. That number is about 150 and is set by the size of our brain. Second, the quality of your relationships depends on the amount of time you invest in then. We invest a lot in a small number of people and then distribute what's left among as many others as we can. The problem is that if we invest little time in a person, our _ with that person will decline until eventually it dies into "someone I once knew".
This is not, of course, to say that the Internet doesn't serve a socially valuable function. Of course it does. But the question is not that it allows you to increase the size of your social circle to include the rest of the world, but that you can keep your relationships with your existing friends going even though you have to move to the other side of the world.
In one sense, that's a good thing. But it also has a disadvantage. If you continue to invest in your old friends even though you can no longer see them, then certainly you aren't using your time to make new friends where you now live. And I suspect that probably isn't the best use of your time. Meaningful relationships are about being able to communicate with each other, face to face. The Internet will slow down the rate with which relationships end, but it won't stop that happening eventually. [/INST] question: The number of friends we can keep relationships with is decided by _ . | options: A: the Internet B: the time we have C: the place we live D: the mind | answer: D </s> |
<s>[INST] context: Five boys are suspected of starting a fire that destroyed their school on the eve of the new term. Police said yesterday that five boys -- one aged 11, two 12-year-olds, one aged 13 and one 15 -- arrested on suspicion of starting the fire had been released until later this month. Parents said the five pupils all attended St Mary's.
Pupils witnessed their schoolwork being destroyed in the fire at Leyland St Mary's Catholic Technology College in Lancashire. The 1950s science block was reduced to the ground in Sunday's fire, which created clouds of smoke visible for miles. It is reported that the library and sports hall were also destroyed beyond repair. Strong winds and a shortage of water prevented 125 firemen trying to bring it under control. Firefighters were expected to remain at the scene until late this afternoon. Staffs were due to attend the school yesterday for an inset day, and pupils pupils were to return for lessons after the holidays today.
St Mary's head teacher Kathy McNicholas fought back the tears as she watched her school go up in flames last night. She said, "This is so upsetting to watch. It's heartbreaking. It's very _ for the staff and the children. Everyone had been looking forward to coming back for the new school year." Finding somewhere around 730 children won't be easy. A few of the staff have turned up to see if there is anything they can do and they have all been shocked and saddened by what has happened. "It's tragic because we have only just had a lot of refreshment work done to the school during the summer break. It was a big investment. The community around here very much looks after its school."
Plans were being drawn up to provide alternative classrooms for 730 children, with parents warned to keep them at home for at least the rest of the week. [/INST] question: Which part of St Mary's Catholic Technology College was burned to the ground in the fire? | options: A: The library B: Sports hall C: The science block D: The passage doesn't tell us | answer: C </s> |
<s>[INST] context: The Luck of the Irish
Look at a map of Britain, and the island on the left is Ireland. It's a small but beautiful country with a long tradition of folk music. Up until 10 years ago just about the only thing that Ireland was famous for was its specialty black beer.
Now Ireland is famous around the world for its music with names like "Kenya","U2" ,"Van Morrison"and more recently "the Corers". "Boyzone",one of the world's top boy bands ,is from Ireland too.What's more,Boyzone member shane has twin sisters,Adele and Heavy,who are members of "B Witched"
The "Boyzone"story is interesting because they were created in 1993 by Dublin nightclub owner John Reynolds.They advertised in newspapers to find members for the group and 300wannabe pop stars applied!
Ronan,who was just 17 when he dropped out of school to make his bid for stardom,and shane,who had been working as trained mechanic in his father's garage when he left to join Boyzone,were both lucky enough to be chosen. The other members are shoe-shop attendant stephen lately,former mechanic Mike Graham and one-time clothes store assistant Keith Dully.
Many people expect bands that have been created by the music industry to produce boring music which doesn't become popular. Even the boys themselves knew they the would not easily achieve international pop music success.
Boyzone quickly proved that they were more than just pretty faces and have sold millions of records around the world.At the moment ,they are not big stars in America,but they say that will change,when they begin a tour of the United States.
Ronan will shortly also start recording as a solo artist. That does not mean the band will spilt yet,but we can expect Boyzone to split sometime in the next 18 months or so.Ronan has also recently become involved as one of the managers of new Irish boy band "West Life" whose song "Swear It Again"has recently been Number 1 in the British charts. [/INST] question: Ireland is famous for _ now. | options: A: its black beer B: its long tradition C: popular music D: its scenery | answer: C </s> |
<s>[INST] context: A tourist comes out of the airport.There are a lot of taxis,but the tourist asks every taxi--driver his name.He takes the third taxi.It costsPS5 from the airport to the hotel."How much does it cost for the whole day?" the tourist asks."PS100",says the taxi-driver.This is very expensive,the tourist accepts the price.
The taxi--driver takes the tourist everywhere.He shows him all monuments and all the museums.In the evening they go back to the hotel.The tourist gives the taxi-driverPS100 and says,"What about tomorrow?" The taxi-driver looks at the tourist."Tomorrow? It's anotherPS 100 tomorrow."But the tourist says,"That's OK.If that's the price,that is the price.See you tomorrow."The taxi--driver is very pleased.
The next day the taxi-driver takes the tourist everywhere again.They visit all the museums and all the monuments again.And in the second evening they go back to the hotel.The tourist gives the taxi--driver anotherPS100 and says,"I'm going home tomorrow."The taxi-driver is sorry.He likes the tourist and,above all,PS100 a day is good money."So you are going home.Where do you come from?" he asks.
"I come from New York."
"New York!" says the taxi-driver,"I have a sister in New York.Her name is Susannah.Do you know her?"
"Of course 1 know her.She gave mePS200 for you." [/INST] question: The tourist is _ . | options: A: an Englishman B: a Frenchman C: a Swedish D: an American | answer: D </s> |
<s>[INST] context: SAH- Thunder clap headache Cause- Rupture of berry's aneurysm If at post. communicating aery rupture-Involves oculomotor Nerve -So, Dilated pupils -Meningitis - Headache + fever + Nuchal rigidity -Brainstem encephalitis- Altered sensorium autonomic insufficiency -Acute ischemia of Brain/ Stroke - Aletred sensorium Quadri/ Para/ Hemiplegia. Prodromal symptoms suggest the location of a progressively enlarging unruptured aneurysm. A third cranial nerve palsy, paicularly when associated with pupillary dilation, loss of ipsilateral (but retained contralateral) light reflex, and focal pain above or behind the eye, may occur with an expanding aneurysm at the junction of the posterior communicating aery and the internal carotid aery. A sixth nerve palsy may indicate an aneurysm in the cavernous sinus, and visual field defects can occur with an expanding supraclinoid carotid or anterior cerebral aery (ACA) aneurysm. Occipital and posterior cervical pain may signal a posterior inferior cerebellar aery or anterior inferior cerebellar aery aneurysm ). Pain in or behind the eye and in the low temple can occur with an expanding MCA aneurysm. Thunderclap headache is a variant of migraine that simulates an SAH. Before concluding that a patient with sudden, severe headache has thunderclap migraine, a definitive workup for aneurysm or other intracranial pathology is required. [/INST] question: A patient presented with sudden onset on thunderclap headache & dilated pupils. Finding are consistent with: | options: A: Meningitis B: Brain stem encephalitis C: Acute ischemia of midbrain D: Acute aneurismal hemorrhage | answer: D </s> |
<s>[INST] context: What do American middle school students like to be in the future? Some students say they want to be doctors or singers. Some want to be bank clerks or office workers. But Kelly Brown, 13, wants to be a *vegetarian chef. It is a new and interesting job. Kelly Brown wants be a chef because she doesn't eat things from animals. Now she has a problem. She can't find any vegetarian chefs on the computer, so she says she will be the first vegetarian chef, and also the best one in the U.S.A..
Kelly Brown has a *website for herself and other people. It is www.theveggiechef.net. She makes cooking *videos. "I don't like to cook with things from animals," she says. "When I want one egg, I just put in water and *arrowroot. It *tastes the same as an egg."
Now her website is very popular and it helps many people a lot. Every day about 3,000 people learn to cook a healthy meal there. To thank her for helping animals, the organization PETA calls her a "Kind Kid". Do you want to be a vegetarian chef like Kelly Brown? [/INST] question: Kelly Brown is a 13-year-old student from _ . | options: A: England B: Australia C: Canada D: the USA | answer: D </s> |
<s>[INST] context: Sensitivity is defined as the ability of a test to detect the presence of a disease in those who truly have the disease. It is calculated as the number of people with a disease who test positive (true positive) divided by the total number of people who have the disease (true positive+ false negative). In this case, sensitivity equals the number of babies born with trisomy 21 whose mothers tested positive (100) divided by the total number of babies born with trisomy 21. This yields 100/200 = 50% (not a very sensitive test). 40% corresponds to the prevalence of the disease in the tested population, which in this case equals the total number of babies with Down's syndrome (true positive + false negative = 100 + 100= 200) divided by the total number of people tested (500). This yields 200/500= 40%. 67% corresponds to the positive predictive value of the test, which equals the number of babies with Down's whose mothers test positive (true positives = 100) divided by the total number of mothers testing positive(true positive + false positive = 150). This yields 100/150 = 67%. 71% corresponds to the negative predictive value of the test, which equals the number of normal babies whose mothers tested negative (250) divided by the total number of people testing negative (350). This yields 250/350 = 71%. [/INST] question: An experimental diagnostic test is developed to noninvasively detect the presence of trisomy 21, Down's syndrome. The test is administered to a group of 500 women considered to be at risk for a Down's fetus based on blood tests. The results of this test are shown below. What is the sensitivity of this new test? Trisomy 21 Normal Karyotype Positive Test 100 50 Negative Test 100 250 | options: A: 40% B: 50% C: 67% D: 71% | answer: B </s> |
<s>[INST] context: Germ line mosaicism In some autosomal dominant disorders examplifled by osteogenesis imperfecta, phenotypically normal parents have more than one affected child. - This clearly violates the law of inheritance. Studies indicate that gonadal mosaicism may be responsible for such unusual inheritance. Mosaicism It means than an individual has 2 or more different cell lines derived from a single Zygote. - The persons body' is made up of a combination of cells with and without mutation for a paicular disease. - Because the mutation remains limited to a small poion of all of the body's cells, these individuals show no sign of the disease. Germline mosaicism Germline mosacism results from a mutation that occurs postzygotically during early embryonic development. In these a poion of the egg or sperm cells of a parent carries the mutation. - Because the mutation affects only cells destined to form the gonads the gametes carry the mutation but somatic cells of the individual are completely normal. - A phenotypically normal parent who has germ line mosaicism can transmit the disease causing mutation to the offspring through the mutant gamete. - Because the progenitor cells of the gamete carry the mutation there is a definite possibility that more than one child of such a parent would be affected. - Obviously, the likelihood of such an occurrence depends on the propoion of germ cells carrying the mutation. Anticipation The signs and symptoms of some genetic conditions tend to become severe and appear at an earlier age as the disorder is passed from one generation to the next. - This phenomenon is called anticipation. Anticipation is most often seen with ceain genetic disorders of the nervous system such as Huntington's disease, Fragile x-syndrome and myotonic dystrophy. Anticipation typically occurs with disorders that are caused by an unusual type of mutation called a "trinucleotide repeat expansion". - A trinucleotide repeat is a sequence of three DNA building blocks (nucleotide) that is repeated a number of times in a row. - DNA segments with an abnormal number of these repeats are unstable and prone to errors during cell division. - The number of repeats can change as the gene is passed. from parent to child. - If the number of repeats increases it is known as trinucleotide repeat expansion. - In some cases the trinucleotide repeat may expand until the gene stops functioning normally,. - This expansion causes the feature of some disorders to become severe with each successive generation. Genomic imprinting People inherit two copies of their genes - one from their. father and one from their mother. Usually both copies of each gene are active or "turned on" in cells. But with genomic imprinting however, only one of the two copies is normally turned on. Which copy is active depends upon the parent of origin. Some genes are normally active only when they are inherited. from a person's. father, others are active only when inherited from a person's mother. These genes are called "imprinted genes" because the gene was epigenetically silenced or marked in either the egg or sperm. Silencing or imprinting usually happens through the addition of methyl groups during egg or sperm formation. An individual normally has one active copy of an imprinting gene. Improper imprinting can result in individual having two active copies or two inactive copies. - This can lead to severe developmental anomalies, cancer and other problems e.g., - Prader willi - Angelman syndrome - They are both linked to same imprinting region of chromosomes 15. [/INST] question: Two siblings with osteogenesis imperfect, but their parents are normal. Mechanism of inheritance is aEUR' | options: A: Anticipation B: Genomic imprinting C: Germ line mosaicism D: New mutation | answer: C </s> |
<s>[INST] context: Apoptosis Annexin V assays provides simple and effective method to detect apoptosis at a very early stage. This assay makes advantage of the fact that phosphatidylserine (PS) is translocated from the inner (cytoplasmic) leaflet of the plasma membrane to the outer (cell surface) leaflet soon after the induction of apoptosis and that the annexin V protein has strong specific affinity for phosphatidyl serine. Phosphatidyl serine on the outer leaflet is available to bind labelled annexin V providing the basis for a simple staining assay. All of the annexin proteins share the propey of binding calcium and phospholipids. Annexin V is a cause of syndrome called antiphospholipid antibody syndrome. Annexin V normally forms a shield around ceain phospholipid molecules that blocks their entry into coagulation (clotting) reactions. In the antiphospholipid antibody syndrome; the formation of the shield is disrupted by the abnormal antibodies. Without the shield, there is an increased quantity of phospholipid molecules on cell membranes speeding up coagulation reactions and causing the abnormal blood clotting characteristic of antiphospholipid antibody syndrome. [/INST] question: Annexin V is a marker of aEUR' | options: A: Apoptosis B: Necrosis C: Aherosclerosis D: Inflammation | answer: A </s> |
<s>[INST] context: It's 10 pm. You may not know where your child is, but the chip does.
The chip will also know if your child has fallen and needs immediate help. Once doctors arrive, the chip will also be able to tell them which drugs are not suitable for little Johnny or Janie. At the hospital, the chip will tell doctors his or her complete medical history. And of course, when you arrive to pick up your child, settling the hospital bill with your health insurance policy will be a simple matter of waving your own chip-the one embedded in your hand.
To some, this may sound unbelievable. But the technology for such chips is no longer the stuff of science fiction. And it may soon offer many other benefits besides locating lost children or elderly patients. It could be used as credit cards and people won't have to carry wallets anymore.
On the other hand, some are already wondering what this sort of technology may do to the sense of personal privacy and liberty.
"Any technology of this kind could result in abuse of personal privacy," says Lee Tien, senior staff attorney for the Electronic Frontier Foundation. "If a kid can be tracked, do you want other people to be able to track your kid? It's a double-edged sword."
Applied Digital Solutions, Inc. in Palm Beach, Florida, says it has recently applied to the Food and Drug Administration for permission to begin testing its device in humans. About the size of a grain of rice, the microchip can be encoded with bits of information and embedded in humans under a layer of skin. When scanned by a nearby reader, the embedded chip gives the data.
Most embedded chip designs are so-called passive chips, which give information only when scanned by a nearby reader. But active chips-such as the proposed Digital Angel of the future-will give out information all the time. And that means designers will have to develop some sort of power source that can provide a continuous source of energy, yet be small enough to be embedded with the chips.
In addition to technical problems, many suspect that all sorts of legal and privacy issues would have to be cleared as well. [/INST] question: What is the attitude of Lee Tien towards the chips? | options: A: Negative B: Indifferent C: Arbitrary D: Cautious | answer: D </s> |
<s>[INST] context: Well I decided to cut my front lawn today, especially since I live on a main street downtown with lots of traffic. Anyway, I finished mine and decided to cut my neighbor--Jean's grass while I was at it. She is a sweet person who has gone through some _ times in the last year. Her brother passed away of cancer last year; her sister (who lives with her) is mentally challenged--yet so sweet!
It was a difficult time with physical and mental challenges that led her employer in our local hospital to let her go after 25 years of service! Lastly, my neighbor Jean, who is a nurse in our local hospital, was diagnosed with esophageal cancer in December. She went through radiation and a long recovery--but thankful she is in remission .
Anyway, in short I was leaving my house this afternoon and she stopped me to thank me for cutting her grass. She told me her dad passed away on Friday and she just arrived home from the funeral service, so she didn't know when I would have time to cut her grass. So, when she arrived home and saw it cut she was more than happy and grateful! I said to her "You are welcome, just a small act of kindness for a neighbor."
I did it for exercise and shared pleasure not knowing it meant more to her than just doing a neighbor a favor! [/INST] question: Although a lot of unfortunate matters happened to Jean, she is still _ . | options: A: pessimistic B: optimistic C: depressed D: disappointed | answer: B </s> |
<s>[INST] context: Hea Rate "A significant misconception is that shock occurs only with low B.P.(hypotension). Through various compensatory mechanisms hypotension is often a late .finding. Tachycardia, with or without tachyapnea may be the 1' or only sign of early compensated shock". Shock is an acute dramatic syndrome characterized by inadequate circulatory supply of oxygen so that the metabolic demands of vital organs and tissues are not met. Shock has been categorized into series of recognizable stage: ? Compensated Uncompensated Irreversible An initial insult triggers shock, thus disrupting blood flow to end organs leading to inadequate tissue perfusion. The body's compensatory mechanism is initiated to maintain perfusion to vital organs. If treatment is not introduced during this period, decompensated shock develops causing tissue damage that leads to multisystem organ dysfunction and death. Compensatory shock In the early phases of shock, multiple compensatory physiologic mechanisms act to maintain blood pressure and preserve tissue perfusion. - Blood pressure remains normal, initially, because of peripheral vasoconstriction and increased systemic vascular resistance. - Thus hypotension occurs late and is more a characteristic of uncompensated stage of shock. - Patients in compensated shock have relatively normal cardiac output and normal blood pressures but they have alteration in microcirculation that increase flow to some organs and reduce flow to other. - In infants compensatory increases in cardiac output are achieved primarily by "tachycardia" rather than by increase in stroke volume. - Hea rates of 190-210/min are common in infants with compensated shock. - On the other hand in older patients cardiac contractility (stroke volume) and (hea rate) increase to improve cardiac output. [/INST] question: Most sensitive indicator of intravascular volume depletion in infant aEUR' | options: A: Stroke volume B: Hea rate C: Cardiac output D: lood pressure | answer: B </s> |
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