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<s>[INST] context: It was the last day of the final examination in a university. A group of students entered the classroom happily. This was their last exam. They knew it would
be easy. The professor had said that they could bring any book or note they wanted. The only requirement was that they couldn't talk with each other.
The professor handed out the papers. They were glad to find there were only five questions. Three hours passed. The professor asked, "How many of you have finished all the five questions?" None of the students answered.
"How many of 3'ou have finished four?" No answers again.
"Thee? Two?" The students moved restlessly in their seats.
"One, then? Certainly somebody has finished one." But the class remained silent.
"That is exactly what I expected," the professor said. "I just want to teach you a lesson--although you have completed four years of study, there are still many
things you don't know about." Then be added, "You will all pass the exam, But remember: even though you are graduating from college, your education has just begun." [/INST] question: How many students passed the exam at last? | options: A: None of them B: Only one C: Half of them D: All of them | answer: D </s> |
<s>[INST] context: Causes of Paralytic ileus
Postoperative - a degree of ileus usually occurs after any abdominal procedure and is self-limiting, with a variable duration of 24-72 hrs. Post op ileus may be prolonged in the presence of hypoproteinemia or metabolic abnormality.
Infection
Peritonitis
Intrabdominal abscess
Sepsis
Pneumonia
Electrolyte abnormalities
Uremia
Hypokalemia
Hyponatremia
Hypomagnesaemia
Hypermagnesemia
Medication
Anticholinergics
Opiates
Phenothiazines
Calcium channel blocker
Tricyclic antidepressants
Spinal cord injury
Retroperitoneal hemorrhage
Myocardial infarction
Mesenteric ischemia
Hypothyrodism
Ureteric colic
Paralytic ileus is a state in which there is failure of transmission of peristaltic waves secondary to neuromuscular failure.
The resultant stasis leads to accumulation of fluid and gas within the bowel with associated distention, vomiting, absent or diminished bowel sounds and absolute constipation.
Radiological picture shows dilated gas filled bowel loops with multiple air-fluid level.
The picture is similar to mechanical small bowel obstruction; the only differentiating point is presence of gas in colon and rectum in paralytic ileus.
Other clinical differentiating features of paralytic ileus from mechanical small bowel obstruction are.
Pain - Pain is colicky in mechanical obstruction. Pain is not a feature of paralytic ileus and if present is a steady, diffuse pain.
Bowel sounds - Bowel sounds are hypoactive or absent in paralytic ileus in contrast to hyperactive bowel sounds in mechanical obstruction. [/INST] question: Paralytic ileus is seen in -a) Spinal cord injuryb) Hypocalcemiac) Hypermagnesemiad) Uremia | options: A: b B: ad C: ac D: ab | answer: B </s> |
<s>[INST] context: My 18-month-old son, Adam, called from the front door. "Look, Mama! Doggie!" I dropped what I was doing and stuck my head out the door. Brandy, our next-door neighbor's 11-year-old dog, was over again. "Go away!" I shouted.
Brandy's owner had died about a month earlier. The woman's family had emptied the house and stuck a "For Sale" sign in the front yard, but the family had left old Brandy behind. For weeks, she'd been wandering around the neighborhood.
It wasn't that I disliked dogs or anything like that. I just didn't think about them very much. I never had a dog growing up and had never thought to get one.
Brandy went away and I stayed outside with Adam. Then the phone rang. I went inside to take the call. When I came back, Adam was gone. I searched the yard, front and back, then the basketball court and public pool. No trace of him. I was so nervous that I ran home and called the police, then my husband.
Police searched the neighborhood. Suddenly I heard another sound: a dog barking. "It's coming from the woods," one of my neighbors said. We followed the barking to a wooded cliff . There we found my son, and he was just inches away from the edges of the cliff, fast asleep. Brandy was beside him, leaning against him to keep him away from the edge. When I picked Adam up, Brandy sank down on her side, breathing quickly. She must have been holding Adam there for hours!
I thanked the police and brought Adam and Brandy back to our house. She hesitated a moment on our doorstep, no doubt remembering the time I'd driven her away.
"Come on, girl," I said. "This is your home now." Brandy stepped in, and once she saw she was really welcome, she relaxed and lay down on the floor just inside the door. She'd done a great thing, and I wondered if she knew it . She'd certainly touched me in a way that no animal ever had. What a pity a dog like Brandy had been left behind! [/INST] question: What did the woman do when she first saw Brandy? | options: A: She gave her some food B: She drove her away C: She took her home D: She said thank you to her | answer: B </s> |
<s>[INST] context: Many families find that when it comes to a Caribbean getaway, they prefer bigger hotels. If you're considering an Aruba vacation, there are plenty of resorts that will suit your every need.
Aruba Marriott Resort and Casino
This resort is on Aruba's famous palm Beach, and has the largest rooms of all Aruba hotels. A recent upgrade gives it a very fashionable look and feel. The resort offers excellent services on site including delicate fine dining and a 24-hour casino.
Hyatt Regency Aruba Resort
Popular with families, this resort stands out by its style and elegance. The most attractive aspect is the Spanish-style architecture and garden-like grounds. you will find waterfalls flowing into the beautiful man-made lake which add to the relaxing atmosphere. This hotel offers plenty to enjoy.
Renaissance Aruba Ocean Suites
This resort is absolutely fantastic for families with young children and features 40 acres of private beaches. The pool complex features several outdoor pools, two pool-side bars, and a swim-up bar. There is also a kids club which offers many activities. Guests at this hotel even have full access to the Radisson Aruba Resort Casino & Spring.
Occidental Grand Aruba
This resort is set on a beautiful white sandy beach and offers everything from sailing to late-night dancing. There is always plenty to do on the resort free of charge, but if you want to pay a little extra you can book yourself in for deep-sea fishing, golf, or private tennis lessons. [/INST] question: What is the main characteristic of Hyatt Regency Aruba Resort? | options: A: Its large rooms B: Its sandy beach C: Its outdoor pools D: Its style and elegance | answer: D </s> |
<s>[INST] context: Flagillary hemagglutinin, peussis toxin, fimbrial Whole cell peussis vaccines consist of inactivated Bordetella peussis bacterial cells. - They arc given as combinations with diphtheria and tetanus toxoids (DTP) vaccines. - Whole cell DTP vaccines cause several local adverse effects. (e.g., erythema, swelling pain at the injection site) and other mild systemic events e.g., (drowsiness, .fretfulness and anorexia). - They are also associated with serious systemic adverse effect such as convulsions with or without fever and hypotonic hyporesponsive episodes sometimes they may also be associated with encephalopathy. Concerns about the safety prompted the development of more purified (Acellular) peussis vaccine that are associated with a lower frequency of adverse effects and are as effective in preventing peussis as the whole cell vaccine. There is yet no consensus about the antigenic composition of an ideal acellular peussis vaccine. A cellular peussis vaccines currently available .from different manufactures should be considered as different and unique products because of the presence of one or more different components which are : ? - Chemically or genetically detoxified peussis toxindeg (PT toxoid). - Filamentous hemagglutinin - 69k Da outer membrane protein (also known as peactin)deg - Fimbrial-2 and fimbrial-3 antigens. - These components are contained in different concentrations and with different degrees of adsorption. - It was believed that active peussis toxin and endotoxin are responsive for the high incidence of adverse effects of whole cell vaccine. - There fore the acellular peussis vaccine contains detoxified peussis toxin or the toxoided peussis toxin and it does not contain the endotoxins present in whole cell peussis vaccine. They are associated with considerably lesser side effects than whole cell vaccine and have similar efficacy to a cellular peussis vaccine (90%). [/INST] question: Acellular peusis vaccine contains | options: A: Peactin, flagillary hemagglutinin, cytotoxin, endotoxin B: Peactin, flagillary hemagglutinin, fimbriae, endotoxin C: Peactin, cytotoxin, fimbriae, peactin, D: Flagillary hemagglutinin, peusis toxin, fimbriae | answer: D </s> |
<s>[INST] context: Mixed astigmatism has best visual acuity In the case of mixed astigmatism the circle of least diffusion is nearest to the macula so it has best visual acuity. Simple Myopic Astigmatism One ray focused at Retina Other focused in front Simple Hyperopic Astigmatism One ray focused at Retina Other focused behind Compound Myopic Astigmatism Both rays focused in front Retina Compound Hyperopic Astigmatism Both rays behind the Retina Sturm's Conoid Configuration of rays refracted through toric surface when point Object is focused Curvature of veical plane (V) is more than hirizontal plane (H), hence FHis < Fv.(rays coming in veical plane converge more and earlier in their course as compared to horizontal rays ) POINT in stums's conoid CHRACTESTIC Point A Horizontal oval image is formed as Veical Rays(plane V) converge more than horizonatal rays Point B (Fv) veical rays converge completely ,horizontal line is formed Points C after convergence of veical rays at focal point they sta to diverge , horizontal rays are still converging-horizontal oval image Point D divergence of veical rays = convergence of horizonatl rays hence perfect circular image formed K/a Circle of least Confusion Point E horizonatal rays convrege more than divergence of veical rays ,hence veically oval circle is obtained Point F(FH) horizontal rays converge completely hence we onbtain only vetical straight line Point G both horozonatal and veical rays diverge hence Veically oval circle A/K/A Prolate ellipse [/INST] question: Which of the following type of Astigmatism has best visual quality | options: A: Simple myopic Astigmatism B: Compound myopic Astigmatism C: Mixed astigmatism D: Oblique Astigmatism | answer: C </s> |
<s>[INST] context: World Expo 2010 Shanghai China is to be staged in Shanghai from May1 to October 31, 2010. If you plan to visit the Shanghai Expo this summer, China Pavilion is a must-see area for you.
China Pavilion, which is called Oriental Crown , is located at the center of the Expo site. Standing 63 meters tall, the China Pavilion takes the shape of an emperor's crown, with the upper layers larger than the lower ones. Covering 160,000 square meters in floor space, the pavilion consists of a national hall and a regional hall. Construction on the China Pavilion began on December 18, 2007. The design of the China Pavilion was picked from a total of 344 designs put forward by Chinese from around the world. The pavilion possesses both traditional and modern features, which helps develop the theme of the 2010 Expo: " Better City, Better Life". For example, it is red in appearance, which contains the elements of traditional Chinese culture, and it is green indoors, with the use of energy-saving techniques. The Shanghai World Expo is expected to attract 70 million visitors from across the globe. It is estimated that 400,000 people will visit the Expo and its 140 pavilions every day during the period, but the China Pavilion is only able to receive about one tenth of the total. How to accommodate so many people in the pavilion remains a tough task. Luckily, the China Pavilion is built as a permanent landmark.
During the Expo, the main structure will be used for an exhibition based on the theme of " Chinese wisdom in urban development" by explaining the values of harmony, nature and spirit. The three-story pavilion has three sections. The top floor's "Footprint of the East" will show some of the changes in Chinese cities. There, you can see a film which shows how Chinese cities have changed, especially in the past 30 years. According to Lu Chuan, director of the film, the scenery is like something from Lord of the Rings. On the second floor, "Journey of Wisdom" will explain China's four great inventions. And the ground's "Blossoming City" will display scenes from cities of the future. [/INST] question: Which of the following words can be used to describe the China Pavilion? | options: A: Tiny B: Round C: Exotic D: Environmentally-friendly | answer: D </s> |
<s>[INST] context: There are many international organizations which work to save and protect endangered species and natural environment. If you would like more information about any of the organizations listed below, you can write to the addresses given.
Friends of the Earth
Friends of the Earth (FOE) campaigns on a range of problems including rainforests, the countryside, water and air pollution and energy.
Friends of the Earth International Secretariat P.O. Box 19199
1000 G. D.
Amsterdam
The Netherlands
Greenpeace
Greenpeace uses peaceful but direct action to defend the environment. It campaigns to protect rainforests and sea animals, stop global warming and end pollution of air, land and seas. It also opposes nuclear power.
Greenpeace International
Keizergracht 176
1016 DW Amsterdam
The Netherlands
BirdLife
INTERNATIONAL
BirdLife International is an organization which works to save endangered birds all over the world.
BirdLife International
Wellbrook Court
Girton Road
Cambridge CB3 ONA
England
WWF
WWF-World Wide Fund For Nature is the world's largest private international organization for the protection of nature and endangered species.
Information Officer
WWF International
Avenue du Mont-Blanc
1196 Gland
Switzerland [/INST] question: If you want to learn more about the organizations, you can _ . | options: A: call them B: write them a letter C: visit them D: send them an e-mail | answer: B </s> |
<s>[INST] context: Long-time exposure to air pollution can lead to physical changes in the brain and cause trouble in learning and memory, and even anxiety. This is suggested by the results of new research on mice.
While other studies have shown the harmful effects of polluted air in the lungs and heart, this is the first to show the negative effect on the brain.
The team of Laura Fonken, Randy Nelson , from the Ohio State University, the USA, has spread to the brain a previous line of research which found that fine particulate matter floating in the air mainly because of air pollution caused by humans, causes swelling in much of the body, and may be related to high blood pressure problems, and some other diseases.
In the research Fonken and his colleagues exposed mice to polluted air for six hours each day, five days a week, over a period of 10 months, almost half the average life length of mice.
Polluted air contains fine particles created by cars, factories and natural dust. Fine particles of this kind are tiny, about 2.5 micrometers in diameter , or about one-thirtieth the width of a human hair. These particles can go deep into lungs and other organs.
The concentration of this particulate material to which they exposed mice is equal to the concentration at which people can be exposed in some polluted urban areas.
After a period of 10 months, the researchers got the animals to have a series of behavioral tests. Both the behavior of mice and the results of neurological tests done to them show that those within the polluted air had more problems in learning and memory, and higher levels of anxiety.
The results suggest that long-time exposure to polluted air can have measurable negative effects on the human brain and can cause a variety of mental health problems. This could have important consequences for those living and working in polluted urban areas. [/INST] question: The results of new research on mice first suggest that polluted air mainly does harm to _ . | options: A: normal organs B: lungs and heart C: mental health D: blood pressure | answer: C </s> |
<s>[INST] context: Chiari malformations: Chiari malformation I: most common peg-like cerebellar tonsils displaced into the upper cervical canal through the foramen magnum Chairi malformation 1.5: described in the literature as both a condition in its own right as well as a variant of Chiari I malformation caudal descent of cerebellar tonsils and brain stem Chiari malformation 2: displacement of the medulla, fouh ventricle and cerebellar vermis through the foramen magnum usually associated with a lumbosacral spinal myelomeningocele. Chiari malformation 3: features similar to Chiari II, but with an occipital and/or high cervical encephalocele. Chiari malformation 4: severe cerebellar hypoplasia without displacement of the cerebellum through the foramen magnum probably a variation of cerebellar hypoplasia Chiari V malformation: absent cerebellum herniation of the occipital lobe through the foramen magnum Chiari 0 malformation: syrinx without cerebellar tonsillar, or brain stem descent infrequently used and confusing term to be avoided based on repos of syrinx improvement after posterior fossa decompression LEMON SIGN: anterior bowing of frontal bone BANANA SIGN: wrapping of cerebellum around brainstem 100 % of lumbar malignancies have Chiari malformation Dandy-Walker malformation: - agenesis of cerebellar vermis - large posterior fossa [/INST] question: "Lemon sign" & "Banana sign" on Antenatal USG is seen in: | options: A: Down syndrome B: Chiari Malformation C: Turner syndrome D: Klienfelters syndrome | answer: B </s> |
<s>[INST] context: • Peyronie’s disease (plastic induration of penis/ penile fibromatosis) usually seen over 40 years of age.
• It is due to fibrous plaques in one or both corpus cavernosum of varying sizes involving tunica albuginea which may later calcify or ossify.
• Cause remains obscure, the dense fibrous plaque is microscopically consistent with findings of severe vasculitis.
• Palmar fibromatosis (Dupuytren’s contracture), plantar fibromatosis and penile fibromatosis (Peyronie’s disease) are components of the same pathological process called superficial fibromatosis.
Clinical Features
• Painful erection, curvature of penis and poor erection distal to involved area.
• No pain when the penis is in nonerect state.
• Palpable induration or mass appears usually on the dorsolateral aspect of the penis.
Treatment
• Spontaneous remission occurs in about 50% cases, so observation and emotional support advised initially.
• If the penile deformity is distressing, Nesbitt’s operation can be performed to straighten the penis.
• Nesbitt operation: Straightening of penis by placing non-absorbable sutures in corpus cavernosum opposite to the plaque. [/INST] question: Palpable fibrous plaque on dorsal penile shaft indicates- | options: A: Paget's disease B: Potter's syndrome C: Prehn's sign D: Peyronie's disease | answer: D </s> |
<s>[INST] context: The lingual nerve initially courses directly underneath the mucosa of the floor of the mouth and superficial to the submandibular gland, specifically the submandibular duct. This nerve is therefore at risk for ligation, division, or trauma during excision of the gland and duct. The lingual nerve is part of the mandibular division of the trigeminal nerve and carries fibers from the chorda tympani. These latter fibers supply taste to the anterior two thirds of the tongue and preganglionic parasympathetic axons involved in salivary gland secretion. Fibers of the trigeminal nerve supply general sensation to the anterior two thirds of the tongue. The lingual nerve passes deep both to the lateral pterygoid muscle and the ramus of the mandible and subsequently travels deep to the submandibular gland itself. The buccal nerve, also a branch of the mandibular division of the trigeminal nerve, supplies the mucosa of the cheek and is not in close proximity to the gland or duct. The inferior alveolar nerve, though close in proximity to the submandibular gland, travels deep to the lateral pterygoid muscle and later enters the mandibular canal to supply the lower teeth. The nerve to the mylohyoid, a branch of the inferior alveolar nerve, supplies the mylohyoid muscle and the anterior belly of the digastric. Neither of these nerves is at risk for damage during excision of the submandibular gland and duct. [/INST] question: A 35-year-old man is admitted to the hospital with severe pain in the area of his right submandibular gland. Radiographic examination reveals a tumor of the gland. An incision is made and the submandibular gland and its duct are removed. Which of the following nerves is most commonly injured in this type of procedure? | options: A: Buccal B: Lingual C: Inferior alveolar D: Nerve to mylohyoid | answer: B </s> |
<s>[INST] context: Austin Children's Museum
This 7,000-square-foot museum focuses on entertaining and educating children up to age 9. In its World City Exhibit , children can go shopping, order lunch at a restaurant, pretend that they're doctors or workers, and more. In other fun exhibits, they learn about Austin's history, explore the world of water, and experience life on a large Texas farm.
Open time:From Tuesday to Saturday, 10:00 a. m. ~5:00 p. m.
On Sunday, 12:00 a. m. ~5:00 p. m.
Address:201 Colorado St, Austin, Texas 78701
Phone:512-4722499
Brooklyn Children's Museum
Founded in 1899, it is the world's oldest children's museum, famous for different exhibits and special events. The Mystery of Things teaches children about cultural and scientific objects and Music Mix welcomes young performers.
Open time:From Wednesday to Friday, 2:00 p. m. ~5:00 p. m.
On Saturday and Sunday, 10:00 a. m. ~5:00 p. m.
Address:145 Brooklyn Ave, Brooklyn, New York 1213
Phone:718-7354400
Children's Discovery Museum
This museum's exhibits explore the connections between the natural and the created worlds, and people of different cultures and times.
Open time:From Monday to Saturday, 10:00 a. m. ~5:00 p. m.
On Sunday, from noon. Closed on holidays.
Address:180 Woz Way, Guadalupe River Park, San Jose, California 95110
Phone:408-2985437
Children's Museum of Indianapolis
This museum is the largest of its kind. Exhibits cover science, culture, space, history and explorations. The largest gallery , the Center for Exploration, is designed for ages 12 and up.
Open time:From Tuesday to Sunday, 10:00 a. m. ~5:00 p. m.
Closed on Thanksgiving Day and December 25.
Address:300 N Meridian St, Indianapolis, Indiana 46208
Phone:317-3343322 [/INST] question: Which of the following is NOT exhibited in Children's Museum of Indianapolis? | options: A: Culture B: History C: Special events D: Explorations | answer: C </s> |
<s>[INST] context: The United States government is back in business. Early Thursday morning, President Barack Obama signed a bill to reopen the government. The budget bill, drafted by Senate late on Wednesday night, raised the government's debt ceiling and averted a serious economic crisis. "With the shutdown behind us," Obama said after the Senate vote, "we now have an opportunity to focus on a sensible budget that is responsible, that is fair and that helps hardworking people all across this country."
Now that a settlement has been reached, formerly furloughed employees have returned to work, national museums and parks are reopening, and the government's gears are slowly beginning to turn again.
Before the shutdown, a federal funding bill went back and forth between the Senate and the House. A major issue was whether or not the government would pay for changes in Obama's healthcare plan. The Senate, with a Democratic majority, wanted to pass a budget that would fund the new healthcare law. But the House, which has a Republican majority, did not want government money used that way. Because an agreement could not be reached on a budget plan, the government was forced to partially shut down.
Sixteen days later, _ have come together to pass a measure that raised the country's debt ceiling. The debt ceiling is the strict legal limit Congress places on the amount of money that can be borrowed each year. Had this agreement not been met by October 17, the U.S. may not have been able to pay its promised payments. This legislation, or law, will fund the government through January 15. During this time, Obama and Congress will work on a long-term spending plan.
The effects of the two-week government shutdown were widespread. In addition to national parks, museums, memorials and monuments were off-limits to visitors. Workers at government-run organizations like NASA and the Environmental Protection Agency were furloughed. Part of the new legislation will pay back the 800,000 workers who were without pay during the shutdown.
Early Thursday, the Smithsonian Institution celebrated the government's reopening on Twitter. "We're back from the shutdown!" they wrote, announcing that museums would reopen Thursday and the National Zoo in Washington on Friday.
To the delight of many people, that also means the return of the zoo's popular live Panda camera. [/INST] question: What may have lead to the government shutdown? | options: A: Economic crisis B: The senate voting C: Dispute on the budget bill D: Lazy people across the country | answer: C </s> |
<s>[INST] context: Do you know why you sleep? You may think it's because you're tired. Or perhaps you've been told sleep is good for you. Yet no one knows exactly why or how people sleep.
Until the early 1950s, most scientists thought the body and brain rested during sleep. Then a scientist watched people sleep. He noticed that during periods of between 5 and 30 minutes each, sleepers' eyes made rapid movements, as if they were watching something. He called these periods REM sleep, for Rapid Eye Movement. Periods when sleepers' eyes did not move he called non-REM sleep.
Whenever the scientist woke people during REM sleep, they were having vivid dreams. Measurements showed that sleepers' pulses went up quickly during REM sleep. Their breathing, heartbeat, and the blood going to the brain also increased. Far from being a time of rest, REM sleep is a time when the body is hard at work. Scientists still don't know the reason for this. Some believe REM sleep makes learning easier. Babies spend a lot of time in REM sleep. Because of this, some scientists believe that REM sleep helps the brain grow. Others think REM sleep is a time for the brain to empty the day's garbage.
One thing all the scientists agree on is that sleep is necessary. Without enough sleep, people make mistakes. Most major car accidents happen during the early morning hours, when people are sleepiest. [/INST] question: During REM sleep, a person's breathing and heartbeat _ . | options: A: stop B: increase C: decrease D: stay the same | answer: B </s> |
<s>[INST] context: The English Fashion recently asked people about their wonderful ideas and plans about things they could do.The magazine asked people the following question, "If you had all the money you wanted, what would you like to do?" About 500 people answered the survey question.
Almost half (49%) of the people in the survey said they would buy material things such as a bigger house or a better car.One fifth (20%) of the people said they would travel to the interesting or famous places.17% answered that they would give money to someone else.They would donate money to a charity or to help poor people.More than half of the rest of the people (about 10%) said they would give money to help medical research .All the other people in the English Fashion survey said they would save money in the bank.They said they didn't know what they would like to do right now, but perhaps in a few years they would find a good use for the money.
"Lots of people think that if they buy bigger and better things, they will feel happier," said Dr Mary Wilson. " However," she said, " _ will not last long.After a while, they won't be happy with them any longer." Dr Wilson thinks the happiest people are those who make a change in people's lives.She thinks those people who give money to someone else or to medical research are thinking more of others at the moment.If they had all the money theywanted, they would change the world. [/INST] question: What is the English Fashion? | options: A: A book B: A magazine C: A newspaper D: A TV programme | answer: B </s> |
<s>[INST] context: For most caffeine consumers, its chief benefit is that it helps you get more done. This is what makes it unusual, says Stephen Braun, author of Buzz: The Science and Lore of Alcohol and Caffeine.
"Its appeal is that it helps us earn more money," he adds. "What makes it different from other drugs is that it's used as a productivity tool -- not for pleasure."
Many of history's creative minds have also been associated with a large amount of caffeine consumption.
According to one biographer, the French novelist and playwright Balzac drank as many as 50 cups of coffee a day. "Were it not for coffee one could not write, which is to say one could not live," he once insisted.
For seven years, the film-maker David Lynch ate at the same Los Angeles diner every day, drinking up to seven sweetened cups of coffee "with lots of sugar" in one sitting, which he said would guarantee that "lots of ideas" arrived.
Ludwig van Beethoven was said to have painstakingly counted out exactly 60 coffee beans per cup when he brewed coffee.
Perhaps recent tales of caffeine excess featured the singer Robbie Williams, who reportedly consumed 36 cups of black coffee and 20 cans of Red Bull a day.
It is the routine task itself, as much as the stimulating effects of caffeine, that makes the process so important, says Mason Currey, author of Daily Rituals: How Artists Work. "A lot of artists use the process of making coffee as a gateway to the creative process," he adds. "You need to get into the right mindset to do that sort of work, and the preparation process provides a focus."
One problem with attempting to control caffeine, says Braun, is that it affects everyone differently -- it is impossible to work out a "safe" limit that works for everyone. "Eventually, you have to become your own scientist -- there isn't an alternative to careful self-experimentation," he says. [/INST] question: Stephen Braun mainly stresses caffeine's _ . | options: A: creating ideas B: improving work efficiency C: helping people to relax D: stimulating people | answer: B </s> |
<s>[INST] context: It was at least tow months before Christmas, when nine-year-old Almie Rose told her father and me that she wanted a new bike. Her Barbi bike was just too old, and it needed repairing as well.
As Christmas came nearer, her dream for a bike seemed to disappear, so we thought, for she didn't mention it again. We were busy buying some beautiful storybooks, a doll house, a holiday dress and toys. Then much to our surprise, on December 24, she said she really wanted a bike more than anything else.
Now we didn't know what to do. It was just toot late. We were busy with Christmas dinner and packing children's presents, parents' presents, a brother's present and friends' presents till midnight.So there was no time to take to buy the "right bike" for our little girl. Thinking that we were parents who would make their children unhappy, we felt guilty and sad.
Suddenly my husband came up with an idea. "What if I make a little bike out of clay and write a note that she could trade in the model bike for a real one?" So he spent the next five hours carefully working with the clay to make a small bike.
On Christmas morning, we were so excited for Almie Rose to open the little box with the beautiful red and white clay bike and the note. She opened and read the note loudly.
She looked at me and Ron and said, "So does this mean I can trade in this bike for a real one?" Smiling, I said, "Yes."
Almie Rose had tears in her eyes when she replied, "I would never trade in this beautiful bike that Daddy made me. I prefer to keep it rather than get a real bike." At that moment, we would have moved the God to buy her every bike on the Earth. [/INST] question: Rose's wish was to _ on Christmas Day. | options: A: get a new bike B: make a clay bike C: receive a doll house D: repair her old Barbi bike | answer: A </s> |
<s>[INST] context: In 8% of cases the left coronary aery (LCA) is dominant because it gives of the posterolateral aery (PLA) and then travels to the cross-section of the AV groove and the posterior interventricular (IV groove) where it gives rise to the left posterior descending coronary aery (PDA) that travels in the posterior IV groove and gives off several septal perforator branches (SP). The SP supply blood to the lower poion of the IV septum.In 85% of patients the right coronary aery (RCA) is said to be "dominant" because it supplies circulation to the inferior poion of the interventricular septum the right posterior descending coronary aery or PDA branch. In these cases the RCA travels to the cross-section of the AV groove and the posterior interventricular (IV groove). Here, it gives rise to the right posterior descending coronary aery (PDA) branch which travels in the posterior IV groove and gives off several septal perforator branches (SP). The SP supply blood to the lower poion of the IV septum. Generally, the dominant RCA also gives rise to the AV nodal branch which supplies blood to the AV node. [/INST] question: If circumflex aery gives the posterior interventricular branch, this circulation is described as? | options: A: Right dominance B: Left dominance C: Codominance D: Undetermined | answer: B </s> |
<s>[INST] context: Michael Jackson was one of the world's best singers. He was born in the middle west of the city of Gary, Indiana,in 1958. He began singing with his four brothers. They called the group, "The Jackson Five". The group became very popular after appearing on a television program. In 1970 the group made their their first record with the name of I Want You Back. It was very popular. One of their hit records was Never Say Goodbye.
Michael was good at dancing as well as singing, for example, his dance moves and moon walking. He was asked to act in a film in 1978 for the first time, and in the same year he made a record on his own, which was sold eight million _ all over the world.
Michael nearly didn't go out because he was too famous. Once his fans went off in a faint when they saw him at the concert. No one can do it by now. He lived in a large house and kept lots of animals. He never ate meat. He often raised money for charity. This made him win the Guinness world Records in 2006. He died on June 25th, 2009, but he would live in our hearts forever. [/INST] question: How many people are there in Michaels's group? | options: A: Three B: Four C: Five D: Six | answer: C </s> |
<s>[INST] context: GVHD occurs when immunologically competent cells or their precursors are transplanted into immunologically crippled recipients, and the transferred cells recognize alloantigen's in the host and attack host tissues. It is seen most commonly in the setting of HSC transplantation but, rarely, may occur following transplantation of solid organs rich in lymphoid cells (e.g., the liver) or transfusion of unirradiated blood. When immune-compromised recipients receive HSC preparations from allogeneic donors, the immunocompetent T cells present in the donor inoculum recognize the recipient's HLA antigens as foreign and react against them. To try to minimize GVHD, HSC transplants are done between donor and recipient that are HLA matched using precise DNA sequencing-based methods for molecular typing of HLA alleles. Acute GVHD Chronic GVHD Within 100 days After 100 days It is believed that in addition to direct cytotoxicity by CD8+ T cells, considerable damage is inflicted by cytokines released by sensitized donor T cells. Grafted CD4+ helper T cells reacting with host B cells an stimulating these cells, some of which are capable of producing auto-antibodies. S: Skin: generalized rash (most earliest and most common) I: Intestine: bloody diarrhea L: Liver/bile duct : jaundice S: Skin : destruction og skin appendage and fibrosis of dermis I: Intestine : esophageal stricture L: Cholestatic jaundice GVHD in case of animal is called runt disease. [/INST] question: Cell responsible for 'Graft versus host disease;' (GVHD) is: | options: A: Donor T cell B: Donor B cell C: Host T cell D: Host B Cell | answer: A </s> |
<s>[INST] context: Ciprofloxacin (prototype) It is the most potent first generation FQ acti\*e against a broad range of bacteria, the most susceptible ones are the aerobic gram-negati\*e bacilli, especially the Enterobacteriaceae and Neisseria. The MIC of ciprofloxacin against these bacteria is usually < 0.1 J.Ig/ml, while grampositive bacteria are inhibited at relatively higher concentrations. The spectrum of action E summarized below: Highly susceptible E. coli K. pneumoniae Enterobacter Salmonella typhi other Salmonella Shigella Proteus Neisseria gonorrhoeae N. meningitidis H. influenzae H. ducreyi Campylobacter jejuni Yersinia enterocolitica Vibrio cholerae Moderately susceptible Pseudomonas aeruginosa Staph. aureus (including few MRSA) Staph. epidermidis Branhamella catarrhalis Legionella Brucella Listeria Bacillus anthracis Mycobact. tuberculosis Organisms which have shown low /variable susceptibility are: Strep. pyogenes, Strep. faecalis, Strep. pneumoniae, Mycoplasma, Chlamydia, Mycobact. kansasii, Mycobact. avium. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:687,688 [/INST] question: Which of the following is an antipseudomonal antibiotic? | options: A: Ciprofloxacin B: Vancomycin C: Cefaclor D: Tetracycline | answer: A </s> |
<s>[INST] context: What do Harrison Ford, Mel Gibson and Phil Collins all have in common? They were all bullied at school.
If you're being bullied, it doesn't mean there is something wrong with you. You have a right to feel safe. If you are being bullied at school, it is the school's responsibility to stop it. If you are being attacked outside of school, the police have the responsibility to help you.
The bully is the one with the problem.
A lot of bullies are already being bullied themselves. They feel powerless and so they look for ways to feel tough at school or in the street.
Often, the bully is envious of other kids, so he picks on those who are cleverer, or those kids who have cool dress or more money. Usually bullies don't like themselves, so they take out their frustrations on someone else, e.g. you.
What can you do?
* Look calm and confident even when you are not! You can practice this in the bathroom mirror.
* If possible, ignore the bully. Bullies want a reaction --if you don't seem upset, or angry, they'll often leave you alone.
* Walk away. Just because a bully starts an argument doesn't mean you have to hang around and finish it.
* Avoid being alone. Bullies are cowards who only pick a fight when they know they can win. If you are with friends, they are more likely to leave you alone.
Get help!
Tell an adult you can trust. This doesn't mean you are weak. In life you often need to get help from other people. When you have a broken leg, you get help from a doctor--it doesn't mean you are weak. If you are being bullied you also get help. Bullies want you to keep quiet. When you speak up, you refuse to play the bully's game. Telling others about the problem is a brave move. [/INST] question: Bullies are usually those who _ . | options: A: are stupid B: are poor C: are full of envy D: have more power | answer: C </s> |
<s>[INST] context: If you struggled to get up for work on Wednesdays, there could be a good reason--it is the day our mood reaches its lowest point. Monday has traditionally been thought of as the most depressing day of the week but according to psychologists, midweek gives more cause for concern in reality. Wednesday represented the lowest point in the week as people were furthest away from the weekend that has either just gone or is coming up and often feel too tired to go on with work.
However, psychologists have found that, on average, people's moods remain about the same on each day throughout the week.
To start their research, the University of Sydney scientists asked around 200 people what they thought their mood would be on each day of the week.
Most said their worst moods were on Monday mornings and evenings but they became increasingly cheerful as the week went on, with their best moods falling on Friday and Saturday mornings and evenings.
When asked why they believed that Friday and Saturday were best, respondents said they saw them as less-structured days when they could choose how to spend their time.
The psychologists then asked a further 350 people how they felt each day.
They found that, on average, people's moods remained about the same on each day throughout the week.Mondays were not as depressing as they had feared and Fridays and Saturdays were not as exciting as predicted.
Professor Charles Areni, who led the study, said the day-of-the-week stereotypes stem from a cultural belief that people are generally happier when they are free to choose their activities compared to when they are engaged in paid work.
In reality, he said, weekends do not often see moods change because they are frequently dominated by productive activities that may require large amounts of energy and begin to feel tired like work. "Day-of-the-week stereotypes like Monday morning blues and Thank God It's Friday are largely illusions," he said. [/INST] question: _ has always been thought as the unhappiest day of a week. | options: A: Monday B: Wednesday C: Friday D: Sunday | answer: A </s> |
<s>[INST] context: People
People is America's No.1 magazine about fascinating people.It's a guide to who and what's hot in the arts,science,business,politics,television,movies,books,music and sports.It is published weekly.
Publisher:The Time Inc.Magazine Company
Cover Price:$211.47
Our Price:$117.00
Issues:53 issues/12 months
Lucky
Lucky is the shopping magazine with the best buys,and the fashion tips you'll need before you hit the stores.What makes Lucky really special is that it gets you the information you need before anyone else has it.
Publisher:Conde Nast Publications Inc.
Cover Price:$35.40
Our Price:$15.00
Issues:12 issues/12 months
Parents
The most trusted magazine for parents who want to raise smart,loving and self-confident children.Each issue has age-specific child-development guidance,advice on your child's health and safety,and the best ways to encourage your child's learning.
Publisher:Meredith Corporation
Cover Price:$42.00
Our Price:$9.97
Issues:12 issues/12 months
Entertainment
This magazine covers movies,television,music,Broadway stage productions,books,and popular culture.Unlike _ like People,its main concentration is on entertainment media and reviews.It's intended for a more general audience.
Publisher:The Time Inc.Magazine Company
Cover Price:$199.50
Our Price:$38.95
Issues:57 issues/12 months [/INST] question: Which of the following targets common readers? | options: A: Lucky B: Entertainment C: Parents D: People | answer: B </s> |
<s>[INST] context: The Rockford police chief and some city officials want to install video cameras in all 100 police cars. They think this will reduce the number of lawsuits against the city. In the last five years, Rockford has paid out more than five million dollars to settle about 40 lawsuits.
The chief said, "If cameras had been in those cars, we wouldn't have had to pay one penny. We're always pulling over drunks or drug users who try to fight the policemen or shoot them. Then they always say that the police started beating them first or started shooting at them first. What nonsense!"
The cost of installing cameras will be about $500 per car. The city council will vote on the plan next Monday. Ten of the 13 council members, when asked about the plan, said that they liked the idea. One member said that it made good financial sense and common sense. If the cameras are supported, they can be installed in all the cars within six weeks.
The police officers gladly support camera use. One officer said that too many people thought the police were _ ; cameras would show citizens that the police told the truth.
Citizen reaction to the idea of police car cameras is mixed. One person said that the police should have started doing this years ago when video cameras were invented. But an elderly man said that cameras were against privacy. "These police are trying to stick their nose into everything," he said. He was going to attend the council meeting to fight the plan. He hoped that other citizens would join him. [/INST] question: How did most council members feel about the plan? | options: A: Worried B: Surprised C: Disappointed D: Satisfied | answer: D </s> |
<s>[INST] context: Jack London had endured more hardships by the age of twenty-one than most people experience in a lifetime. His struggles developed in him sympathy for the working class and a lasting dislike of hard work and provided inspiration for his career as a writer.
London grew up in San Francisco in extreme poverty. At an early age, he left school and supported himself through a succession of un skilled jobs ----working as a paper boy, in bowling alleys, on ice wagons, and in canneries and mills. Despite working long hours at these jobs, London was able to read constantly, borrowing travel and adventure books from the library.
The books London read inspired him to travel, and his job experiences led him to become active in fighting for the fights of workers. He sailed to Japan on a journey aiming at catching seals and joined a cross-country protest march with a group of unemployed workers. After being arrested for vagrancy near Buffalo, New York, London decided to educate himself and reshape his life. He quickly completed high school and entered the University of California.
After only one term, however, the appeal of fortune and adventure proved uncontrollable. London gave up his studies and traveled to the Alaskan Yukon in 1897 in search of gold. Jack London was among the first of these miners. He may have searched for more than gold, however. London once commented, " True, the new region was mostly poor; but its several hundred thousand square miles of coldness at least gave breathing space to those who else would have choked at home." Although he was unsuccessful as a miner, London's experiences in Alaska taught him about the human desire for wealth and power and about humankind's inability to control the forces of nature. While in Alaska, London also absorbed memories and stories that would make him known one hundred years later.
Once back in California, London became determined to earn a living as a writer. He rented a typewriter and worked up to fifteen hours a day, spinning his Alaskan adventures into short stories and novels.
According to legend, London's piles of rejection slips from publishers grew to five feet in height!
Even so, London preserved. In 1903, he earned national fame when he published the popular novelThe Call of the Wild. He soon became the highest paid and most industrious writer in the country. During his career, he produced more than fifty books and earned more than a million dollars. Several of his novels, includingThe Call of the Wild(1903),the Sea-Wolf(1904),the White Fang(1906),have become American classics. In fact, he was a creative writer whose fiction explored several regions and their cultures: the Yukon, California, Hawaii, and the Solomon Islands. He experimented with many literary forms, from traditional love stories and dystopias to science fantasy. His noted journalism included war communication, boxing stories, and the life of Molokai lepers . He was among the most influential figures of his day, who understood how to create a public persona and use the media to market his self-created image of poor-boy-turned-success. London's great passion was agriculture, and he was well on the way of creating a new model for spreading through his Beauty Ranch when he died of kidney disease at age 40. He left over fifty books of novels, stories, journalism, and essays, many of which have been translated and continue to be read around the world. His best works describe a person's struggle for survival against the powerful forces of nature. "To Build a Fire", for example, tells the story of a man's fight to survive the harsh cold of the Alaskan winter. [/INST] question: _ made Jack London reconsider his life in the future. | options: A: His job experience B: The books he read C: Being arrested D: Long-hour work | answer: C </s> |
<s>[INST] context: Turner syndrome (45,X) is the most common karyotypic abnormality causing gonadal failure and primary amenorrhea. Amenorrhea is the result of accelerated atresia of the follicles. The fibrotic ovaries are called streak ovaries. Associated stigmata with Turner syndrome include Gonadal Failure Sho stature Webbed neck, Shield chest, Cubitus valgus low hair line high arched palate multiple pigmented nevi Sho fouh metacarpals Cardiac (30% have coarctation of the aoa), Renal (especially horseshoe kidney), Autoimmune (thyroiditis) Androgen insensitivity is a genotypic male with functional testes but the androgen made by the testes is not recognised by the end organs and hence they reach the periphery and conve to estrogens. This leads to external feminisation. Swyer syndrome is much rarer. This is characterised non functional testes. Hence uterus cervix tubes and upper 4/5th of vagina is made. Lower 1/5th vagina is made by the urogenital sinus.This is the 46xy 'female' .Since there is no working androgens, there is no maculinisation, and also no feminisation since there is no estrogen production. This is a much lesser feminine woman as compared with testicular feminization syndrome [/INST] question: 17 yr girl presents with primary amenorrhea. On examination there is absent breast development, however vagina is normal. USG reveals a hypoplastic uterus and bilateral ovaries are not visualised. Diagnosis is | options: A: Turners syndrome B: Swyer syndrome C: Mullerian agenesis D: Androgen insensitivity syndrome | answer: A </s> |
<s>[INST] context: T-shirts on sale
Item 1: This classic T-shirt is now available in youth sizes. Made from 100% organic cotton, this white T-shirt with a four-color Google logo is a great fit for both boys and girls. It has double-needle sleeves and a double-needle bottom hem ,and comes in children sizes XS-8,S-10,M-12 and L-14. Price:$9.65.
Item 2: The softest, smoothest, best-looking, organic cotton T-shirt available anywhere. This T-shirt is made of 100% organic cotton and is specially designed to satisfy women's need. Price:$13.25.
Item 3: Talk about user-friendliness--not only does this ladies' T-shirt look great. It's likely to be the most comfortable piece of clothing you own. Made of 70% bamboo and 30% cotton, it's antimicrobial . This shirt is so soft, and you may find strangers asking if they can touch you. Color: red with a Google logo screened on the left sleeve in white. Price :$8.86
Item 4: 100% organic cotton T-shirt. This shirt has a flattering and stylish fit for any body type. Other characteristics include a reinforced shoulder construction to maintain shape through repeated washings, and a durable double-needle bottom hem. It comes in white with a full color YouTube logo. Price :$14.50
Item 5: This super comfortable full-zip T-shirt not only meets your eyes. Its unseen benefits include moisture-wicking and antimicrobial _ .It is made of 56% cotton,16% bamboo, and 28% polyester. Price :$55.20.
Item 6: Your purchase of this 100% African organic cotton T-shirt supports the Edun Live cause, which helps create jobs in Africa. These shirts are referred to as "grow to sew African " meaning the farmers, ginners, millers, and stitchers in Africa benefit every time an order is placed. This comfortable and stylish shirt comes in natural color. Price :$13.00. [/INST] question: If you want to have a red T-shirt with a Google logo on it, you'd better choose _ . | options: A: Item 1 B: Item 3 C: Item 4 D: Item 6 | answer: B </s> |
<s>[INST] context: What do people do with their old, out-of-date but still useful computers? Most people don't know what to do with them. Many old computers are put away in homes. Many more are simply thrown out with the rubbish.
Finally, some companies are thinking of ways to bring down the number of old computers. Sony has agreed to help recycle old Sony products . Dell, Hewlett-Packard and other companies now also take back some old computers.
In some countries, laws are being passed, too. Computer companies will have to pay for collecting and recycling their used products. And 70% of computer waste must be recycled. The idea behind the laws is that computer companies themselves should pay the cost. That will encourage them to make computers that are easier and cheaper to repair and upgrade .
Yet while many people are throwing away good computers, others cannot afford them at all. Hundreds of organizations are working to solve this problem. They collect and repair old computers. Some also teach others how to repair computers.
The computers then go to schools, charities and people who need them. Giving a used computer to one of these organizations can turn one person's rubbish into someone else's useful things--and cut down on waste, too. [/INST] question: What do many people do with old computers? | options: A: They repair them B: They sell them C: They send them to others D: They stop using them | answer: D </s> |
<s>[INST] context: Russian President Putin named Time magazine's person of the year
Russian President Vladimir Putin was named Time magazine's "Person of the Year" on December 19th,2007for strengthening stability that made Russia a world power again.
The magazine recognized Putin's "extraordinary feat of leadership in taking a country that was in a mess and bringing it stability," said Richard Stengel, Time's managing editor.
The magazine noted that "Person of the Year" is not an honor or an endorsement but a recognition of leadership that shapes the world.
Putin, who is 56 years old, is very popular in Russia, making a great effort to cause economy to come to life on revenue from oil and natural gas.
Putin recently supported vice-PM Dmitry Medvedev's presidential bid, and said he would accept Medvedev's offer to serve as prime minister if Medvedev is elected March2.
The Kremlin said Wednesday the Time reconnition was seen there as an _ of Putin's role in helpingprefix = st1 /Russiapull out of its social and economic troubles in the 1990s.
Others considered for Person of the Year included Nobel Prize-winner Al Gore and author J.K. Rowling.
This year's choice was a return to the magazine's tradition of picking an individual rather than last year's choice of "You", which refers to anyone creating or using content on the World Wide Web.
Putin is the fifth Russian(or Soviet) leader to be named Person of the Year: Gorbachev, Andropov, Khrushchev and Stalin, who was named twice. [/INST] question: How did Putin try to make Russiaa world power again? | options: A: By performing arms race B: By making war C: By strengthening stability D: By getting foreign help | answer: C </s> |
<s>[INST] context: Propylthiouracil Propylthiouracil is the drug of choice for hypehyroidism during pregnancy. Antithyroid drugs in pregnancy Propylthiouracil and methirnezole are both antithyroid drugs that cross the placenta and can lead to fetal goiter. Methimazole has been associated with "cutis aplasia". Scalp defects cloanal atresia esophageal atresia and increased maternal side effects. Because both medications are equally effective the drug of choice for hypehyroidism in pregnancy is propylthiouracil. Propylthiouracil is not available throughout the world and in those conditions methimazole may be substituted. Antihypeensives in pregnancy Angiotensin conveing enzyme inhibitor (ACE inhibitor) e.g., Enalapril, captopril can cause fetal renal tubular dysplasia in the second and third trimesters leading to oligohydramenios fetal limb contractures, craniofacial deformities and hypoplastic lung development. A recent large coho study found an increased risk of congenital malformations with isolated first trimester exposure to ACE inhibitors. Infants exposed in utero to ACE inhibitors were at increased risk of cardiovascular and CNS malformations. Angiotensin II receptor antagonists have been shown to have second and third trimester findings consistent with ACE inhibitors and are not recommended in pregnancy. Aldosterone We have not got any literature on the use of Aldosterone during pregnancy. We are not sure of it use during pregnancy. [/INST] question: Which can be used in pregnancy aEUR' | options: A: >ACE inhibitors B: >Aldosterone C: >AT receptor antagonist D: >Propylthiouracil | answer: D </s> |
<s>[INST] context: On June 26, 2000, two scientists, called Francis Collins and Craig Venter, told the world that they could read the whole "map" of the human body: DNA. DNA is something that everybody has, and it tells the body what to do. DNA is the reason that we look like our mother and father, because we get some of their DNA to make our own.
People have been trying to understand the human body for a long time. In 1860, Gregor Mendel discovered a special reason why we look the same as other people in our family. It is because of small things named "genes" in our body. In 1953, James Watson and Francis Crick made another discovery and found out that those small parts are real messages written in the DNA with a special language.
In 1961, Marshall Nirenberg and Johann Matthaci found a message in DNA showing how DNA tells the cell to build its parts. Scientists have now found all the words in the DNA map, but we still do not understand what they all do. By understanding what just one "word" means, we can help save more people from several illnesses.
Most people hope that this will help make better medicine and help sick people. Other people worry that when people begin to know more words and find out lots of other information, we might use it in a wrong way, just to make people more attractive, or stop sick people from getting jobs. Man would have to meet a lot of trouble if DNA technic wasn't limited in use. [/INST] question: When did we first know why we look like other people m our family? | options: A: In 1860 B: In 1953 C: In 1961 D: In 2000 | answer: A </s> |
<s>[INST] context: A jobless man wanted very much to have the position of "office boy" at Microsoft. The HR manager interviewed him and then watched him cleaning the floor as a test. "You have passed the test," he said. "Give me your e-mail address and I'll send you the form to fill in and the date when you may start." The man replied, "But I don't have a computer, neither an e-mail." "I'm sorry," said the HR manager. "If you don't have an e-mail, that means you are not living. And anyone who isn't living cannot have the job."
The man left with no hope at all. He didn't know what to do with only $10 in his pocket. He thought and thought. Then he went to the supermarket and bought 10 kilos of tomatoes. He sold the tomatoes from door to door. In less than two hours, he had 20 dollars. He repeated the operation three times, and started to go early every day, and returned home late. Shortly, he bought a cart , then a truck, then he had his own fleet of delivery vehicles . Five years later, the man was one of the biggest food retailers in the US.
One day, one of his friends asked him for his e-mail. He said, "I haven't got one." His friend couldn't believe his ears. "Can you imagine what you could have been if you had an e-mail?" The man thought for a while and replied, "Yes, I'd be an office boy at Microsoft!"
,. [/INST] question: What did the man do for the test? | options: A: He sent e-mails B: He did the cleaning C: He sold computers D: He filled in forms | answer: B </s> |
<s>[INST] context: Baonella henselae is the infective agent of cat scratch disease, which generally presents as regional lymphadenopathy with or without low fevers and headaches. Baonella is a gram-variable pleomorphic rickettsial organism that is introduced to the skin in a cat bite or scratch. It produces a self-limited granulomatous response in the draining lymph nodes. Borrelia burgdorferi is a spirochetal organism that is transmitted by a tick bite (Ixodes spp.), producing Lyme disease. Lyme disease progresses from a skin rash to fevers, headache and pain over about one month. It may produce lymphadenopathy, but is not associated with granuloma formation. Chlamydia psittaci infection occurs after contact with infected bird droppings and produces an atypical pneumonia. The central nervous system may also be involved, but lymph nodes are spared. Chlamydia trachomatis is the chlamydial species that typically produces suppurative nodal granulomas (lymphogranuloma venereum). Coxiella burnetii infection is transmitted by inhaling dusts or drinking milk from infected mammals, especially sheep and cows. The disease in humans, Q fever, is marked by mild nonspecific symptoms or pneumonia, and may progress to myocarditis or hepatitis. [/INST] question: A 16-year-old girl presents with a painfully enlarged lymph node in her right axilla and low grade fever. Peripheral blood counts are within normal limits. The lymph node is biopsied, and numerous granulomas filled with neutrophils and necrotic debris are observed. Which of the following organisms could produce this disease? | options: A: Baonella henselae B: Borrelia burgdorferi C: Chlamydia psittaci D: Coxiella burnetii | answer: A </s> |
<s>[INST] context: Tube/cuff/drapes Oxidant O2/N2O Volatile agents - Desflurane, sevoflurane, halothane, isoflurane - non combustible- Laser surgery - we use laser tube * Covered by a metallic & nonmetallic reflecting layer which is wrapped around the tube* Laser reflecting material is used to cover the tube * So that the tube doesn't catch fire* Usually high volume, low pressure cuff is used, but for laser Sx Low volume, high pressure cuff is used (because we don't want any gas to pass through this cuff from lower airway to upper airway (tight seal) * We don't inflate the tube with air, inflate with H2O+dye added to it (if cuff breaks dye spread in entire area, come to know cuff has damaged, immediately we change the tube)* H2O act as extinguisher Surgical drapes - Are arranged in proper order so that gases doesn't accumulate inside the surgical drape- Wet gauges are used to prevent fire Management of airway fire- Stoppage of O2 +N2O (disconnect the circuit)- Try to extinguish the fire with normal saline or distilled water- Remove the ET tube - Reintubate with fresh ET tube- IV steroid + IV antibiotic- Steroids given to prevent airway edema- Antibiotic to prevent infection- Minimum O2, maximum air There are three elements essential to the creation of an airway fire: heat or an ignition source (laser or electrosurgical unit), fuel (paper drapes, ETT, or gauze swabs),and an oxidizer (O2, air, or N2O). The danger of an airway fire is not limited to general anesthesia. It can also occur during facial procedures under monitored anesthesia care electrocautery used in close proximity to delivered supplemental oxygen. [/INST] question: To prevent combustion during anesthesia what combination is used? | options: A: O2 25% & N2O 75% B: O2 50% & N2O 50% C: O2 25% & He 75% D: O2 75% & N2O 25% | answer: C </s> |
<s>[INST] context: Injury and sepsis result in accelerated protein breakdown with increased urinary nitrogen loss and increased peripheral release of amino acids. The negative nitrogen balance represents the net result of breakdown and synthesis (with breakdown increased and synthesis increased or diminished). Amino acids such as alanine are released by muscle and transported to the liver for incorporation into acute-phase proteins including fibrinogen, complement, haptoglobin, and ferritin. The amino acids also undergo gluconeogenesis to glucose, which is utilized primarily by the brain and other glycolytic tissues such as peripheral nerves, erythrocytes, and bone marrow. Other tissues receive energy from fat in the form of fatty acids or ketone bodies during starvation following major trauma; this helps to conserve body protein. Glutamine is the most abundant amino acid in the blood, and its levels in muscle and blood decrease following injury and sepsis as it is consumed rapidly by replicating fibroblasts, lymphocytes, and intestinal endothelial cells. The use of glutamine may decrease protein catabolism in the intestine and may help prevent atrophy of the gastrointestinal tract in starved and parenterally nourished patients. Along with the counterregulatory hormones (glucagon, epinephrine, cortisol), interleukin 1 appears to mediate muscle breakdown. Recent studies have indicated that TNF (also called cachectin because of the role it plays in muscle wasting in septic or oncologic patients) also may be a principal catabolic cytokine in the traumatized patient. This protein is secreted by macrophages and further affects metabolism by inducing secretion of interleukin 1 and inhibiting synthesis and activity of lipogenic enzymes. [/INST] question: Protein metabolism after trauma is characterized by | options: A: Decreased liver gluconeogenesis B: Inhibition of skeletal muscle breakdown by interleukin 1 and tumor necrosis factor (TNF, cachectin) C: Decreased urinary nitrogen loss D: Hepatic synthesis of acute-phase reactants | answer: D </s> |
<s>[INST] context: Working on a team is a good thing. But it can bring you some troubles. If people on your team are not good at communicating, you may often feel terrible. To create a successful team, good communication is the most necessary part for both team members and the leader. The following are some helpful suggestions.
Don't criticize other people. When someone on your team does something wrong, don't criticize him. You can help him to find out reasons and then help him to solve the problem. Criticizing your team members too often may make them keep away from you. As a result, you may feel lonely.
Think about other people's ideas carefully. When someone tells you about his ideas, you should think about them carefully, no matter how silly they may seem. This shows you are interested in his ideas and makes him feel good.
Listen to other people actively. When someone is speaking to you, you need to listen to him actively. If you're unclear about something, you should ask him about it. By doing this you can clear up any confusion before moving on.
Share your ideas with other people. When you have a new idea, talk about it with your team members. This helps to improve the idea. Besides this, it also helps to improve your relationships between you and your team members. [/INST] question: For team members and the leader, _ is the most necessary part to create a successful team. | options: A: communicating well B: dealing with criticism C: sharing ideas D: listening to others | answer: A </s> |
<s>[INST] context: Rheumatoid ahritis "Inflammation from rheumatoid ahritis results in a higher incidence of tarsal tunnel syndrome."- Current geriatric diagnosis,& treatment By C. Seth Landefeld, Robe Palmer, Mary Anne Johnson p459 "Carpal tunnel syndrome may be the presenting feature of rheumatoid ahritis."- Oxford textbook of rheumatology By David Alan Isenberg, Peter Maddison, Patricia Woo, David Glass, Ferdinand Breedveld 3/e p151 "Thus, compressive neuropathy of the branches of the posterior tibial nerve is a relatively frequent finding in patients with definite or classical RA."- Oxford Journals Medicine Rheumatology Volume 20, Number 3 Pp. 148-150 Tarsal tunnel syndrome Is entrapment neuropathy of the posterior tibial nerve (with or without involvement of the medial calcaneal nerve) within the fibro-osseous tunnel posterior and inferior to the medial malleolus. The tarsal tunnel is bounded superficially by the flexor retinaculum (laciniate ligament). The tibial nerve may be constricted by pressure from without or within this tunnel. Sources of constriction beneath and adjacent to the tarsal tunnel include bone fragments from displaced distal tibial, talar, or calcaneal fractures; tenosynovitis or ganglia of an adjacent tendon sheath; and bone and soft-tissue encroachment in rheumatoid ahritis or ankylosing spondylitis, varicosities, neural tumor (neurilemoma) or perineural fibrosis. Compression of the nerve leads to pain and sensory disturbances over the plantar surface of the foot. The pain may be precipitated by prolonged weight bearing. It is often worse at night and the patient may seek relief by walking around or stamping his or her foot. Paraesthesia and numbness can also be seen. Tinel's percussion test over the posterior tibial nerve may be positive. imaging Studies and Special Tests: Electromyography and nerve conduction studies should be performed but can be normal early in the entrapment. MRI provides excellent visualization of the tarsal tunnel and is indicated if there is suspicion of a space-occupying lesion within the tunnel. Treatment is conservative with ohotic modifications and measures to decrease the inflammation surrounding the involved nerve. A medial arch suppo can be fitted to hold the foot in slight varus. Surgical decompression is performed only in refractory cases [/INST] question: Tarsal tunnel syndrome is caused with which ahritis: | options: A: Ankylosing spondylitis B: Osteoahritis C: Rheumatoid ahritis D: Psoriatic ahritis | answer: C </s> |
<s>[INST] context: Many of us believe that a person's mind becomes less active as he grows older.But this is not true,according to Dr.Lissy F.Jarvik,professor of psychiatry at the University of California,Los Angeles,and a board member of the New Center for Aging at the Veterans Hospital.She has studied the mental functioning of aging persons for several years.For example,one of her studies concerns 136 pairs of twins, who were first examined when they were already 60 years old.As Dr.Jarvik continued the study of the twins into their 70s and 80s,their minds did not generally decline as was expected.
However,there was some decline in their psycho-motor speed. This means that it took them longer to accomplish mental tasks than it used to.But when speed was not a factor,they lost very little intellectual ability over the years.In general,Dr.Jarvik's studies have shown that there is no decline in knowledge or reasoning ability.This is true not only into the 30s and 40s,but into the 60s and 70s as well.
As for learning new things,and ability to remember,studies by Dr.Jarvik and others show that the old are equal to the young.It is true that older people themselves often complain that their memory is not as good as it once was.However,much of what we call"loss of memory"is not that at a11.
In the cases where the older person's mind really seems to decline,it is not necessarilv a sign of a decay due to becoming old or"senility".Often it is simply a sign of a depressed emotional state.This depression usually can be got rid of by counseling with a psychologist,or medicine which fights depression.
In American society,when an older person loses something,we tend to call him or her"senile".But notice that when a younger person loses something,he does not blame it on senility or loss of memory.He finds some other excuse! [/INST] question: A long-term study of 136 pairs of twins showed that the only factor that declined over the years was . | options: A: mental health B: intellectual ability C: the amount of knowledge D: psycho-motor speed | answer: D </s> |
<s>[INST] context: Primary Prevention
Primary prevention aims to avoid the development of a disease or disability in healthy individuals. Most population-based health promotion activities, such as encouraging less consumption of sugars to reduce caries risk, are primary preventive measures. Other examples of primary prevention in medicine and dentistry include the use of fluoridated toothpaste, and vaccinations for infectious diseases like measles, mumps, rubella, and polio.
Secondary Prevention
The focus of secondary prevention is early disease detection, making it possible to prevent the worsening of the disease and the emergence of symptoms, or to minimize complications and limit disabilities before the disease becomes severe. Secondary prevention also includes the detection of disease in asymptomatic patients, with screening or diagnostic testing and preventing the spread of communicable diseases. Examples in dentistry and medicine include screening for caries, periodontal screening and recording for periodontal disease, and screening for breast and cervical cancer.
Tertiary Prevention
The goal of tertiary prevention is to reduce the negative impact of an already-established disease by restoring function and reducing disease-related complications.
Tertiary prevention also aims to improve the quality of life for people with disease. In medicine and dentistry, tertiary prevention measures include the use of amalgam and composite fillings for dental caries, replacement of missing teeth with bridges, implants, or dentures, or insulin therapy for Type II diabetes. [/INST] question: RPD can be classified as which level of prevention? | options: A: Primary level B: Secondary level C: Tertiary level D: Support adjacent mobile teeth with clasp | answer: C </s> |
<s>[INST] context: OUR KIDS ARE AMAZING-especially compared with everybody else's (who seem to cry all the time). How do you show your love for your kids this holiday season? With toys that are smooth and colorful, interactive and exciting. And with ones that have educational value-because you are the boss.
1. FLAX ART HOSPITAL PUZZLE AND PLAY SET
Here is a toy that doesn't need power-and the bike have to put it together themselves. This 50 piece puzzle set is made of soft edged hardwood and makes a complete hospital, with an X ray room. It also includes eight patients, a car and a driver. $135; flaxart.com.
2. TINY LOVE ACTIVITY BALL
Sure, it's cool, but this colorful baby toy also develops problem solving and motor skills. It has a head and legs, a magnetic hand and a tail. Suitable for little ones from 6 to 36 months. $19.95; tinylove.com.
3. ROBOSAPIEN
This small, remote control robot is really powerful. It performs 67 preprogrammed functions , including throwing, kicking, picking up and dancing. You can even program your own function which, sadly, does not include doing windows. $99; robosapienonline.com.
4. MINI PEDAL CAR
Want a Mini Cooper but can't fit the family inside? Get one for the kids. They can jump into this Mini car, which comes in hot orange with a single adjustable seat, and ride away. But it could spoil them for that used car they'll be driving when they turn 16.For ages 3 to 5.$189; minus A. com (click on "gear up," then "Mini motoring gear"). [/INST] question: Which toy is said to have the special design for children's safety? | options: A: ROBOSAPIEN B: MINI PEDAL CAR C: FLAX ART HOSPITAL PUZZLE AND PLAY SET D: TINY LOVE ACTIVITY BALL | answer: C </s> |
<s>[INST] context: Dear Disney,
Last weekend, the four members of my family spent an enjoyable holiday at the Magic Kingdom - Disneyland. And one event made our visit seem truly magical.
We got to the front of the line at Space Mountain, only to find out that our little daughter Gloria couldn't take her ice-cream on the ride. We were so excited that we all forgot ice-cream was not allowed on the ride.
Gloria broke into tears and we all had no idea what to do. Then Murphy, one of the staff members, came over. She bent down and told Gloria that she would hold the ice-cream for her and give it to her when she finished the ride. Gloria said, "Promise? "Then she gave Murphy her ice-cream, and she completely enjoyed the ride.
Sure enough, as we walked out the exit, there was Gloria's new friend with "her"ice-cream. Now you and I both know what happened, because we know that an ice-cream won't last twenty minutes on a summer afternoon in Florida. Murphy knew what time we would get off the ride; she went to the nearest shop and bought a brand-new ice-cream thirty seconds before we walked out the exit. Gloria said, "Thank you, "but I'm sure she thought it was the same ice-cream.
We know that _ tried hard to make our visit special. Thanks so much for going above and beyond!
Yours,
Carmen Rivera [/INST] question: The family's visit to the Magic Kingdom was _ . | options: A: helpful B: awful C: frightening D: amazing | answer: D </s> |
<s>[INST] context: A new study finds that our brains are wired to make music-color connections depending on how the music makes us feel. Mozart's "Flute Concerto No.1 in G Major" is most often associated with bright yellow and orange, whereas his "Requiem in D Minor" is linked to bluish gray, the findings revealed.
US researchers from the University of California, Berkeley, enlisted nearly 100 subjects for a study on music and color. With 37 colors, the UC Berkeley study found that people tend to pair faster-paced music in a major key with lighter, more vivid, yellow colors, whereas slower-paced music in a minor key is more likely to be teamed up with darker, grayer, bluer colors.
"Surprisingly, we can predict with 95 percent accuracy how happy or sad the colors people pick will be based on how happy or sad the music is that they are listening to," said lead author and UC Berkeley vision scientist Stephen Palmer.
In three experiments, the subjects listened to 18 classical music pieces that varied in pace (slow, medium, fast) and in major VS minor keys. In the first experiment, participants were asked to pick five of the 37 colors that best matched the music to which they were listening. Separately, they rated each piece of music on a scale of happy to sad, strong to weak, lively to dull, and calm to angry.
Next, the research team plans to study particiapants in Turkey where traditional music employs a wider range of scales than just major and minor. "We know that in Mexico and the US the responses are very similar," Palmer said. "But we don't yet know about China or Turkey." [/INST] question: What can we know about Mozart's "Flute Concerto No. 1 G Major"? | options: A: It is fast in pace B: It is slow in pace C: It makes us feel upset D: It makes us feel optimistic | answer: A </s> |
<s>[INST] context: - The picture is showing dorsal surface of fetus, having neural tube - have 2 openings anterior neuropore (cranially) - forms brain; posterior neuropore (caudally) - forms spinal cord - On dorsal surface of fetus- Notochord (axial mesoderm) stimulate overlying ectoderm to form | Neural plate ectoderm which becomes | Neural groove | Detaches from dorsal surface, fuses at cervical region & proceed Caudally & cranially forming neural tube Surface ectoderm in periphery come to midline & fuse together forming skin epithelium covering neural tissue Neural Crest Cells at periphery detach from dorsal surface to from Peripheral nervous system - Neural tube - will have 2 opening, which closes during course of development - Non closure leads to Open Neural Tube Defects. 1. Towards head - Cranial/anterior neuropore - closes & form brain by days Non closure of anterior neuropore leads to Anencephaly | Leading to open brain & skull cap Small degenerated brain is present.These fetus doesn't have swallow reflex resulting in polyhydramnios (more Amniotic Fluid) 2. Towards tail - Caudal/Posterior neuropore - closes & form spinal cord by day-28 Non-closure of posterior neuropore leads to Rachischisis Spinal cord & veebra are open (open veebra - spinal bifida) Skin is also open & CSF keep leaking outside Lady with fetus of open neural tube defects will have increased levels of ALPHA FETO-PROTEIN & ACETYLCHOLINESTARASE enzyme Mother with polyhydramnios - check for AFP - If high check for AchE - if high do USG | It may be a case of Anencephaly / Rachischisis - Open neural tube defects can be prevented by giving prophylactic Folic acid supplements Dose - 400ug/day - Antenatal as well as postnatal throughout the pregnancy - Both anencephaly & rachischisis come together forming craniorachischisis. Skin remains at periphery; veebra are open & veebra spines are not fused resulting in spina bifida Spinal cord is open & CSF is leaking out. A - Craniorachischisis B - Anencephaly [/INST] question: The marked structure close at which day of in-utero development (JIPMER May 2019) | options: A: 7 B: 12 C: 25 D: 30 | answer: C </s> |
<s>[INST] context: If you are really interested in music festivals, then you have probably heard of the Bestival Music Festival. It takes place every September on the Isle of Wight, the UK. As it is at the end of summer, people think it's their last chance to go to a festival and have fun before going back to boring work.
The dream begins as soon as you start traveling to the island. In order to get to the campsite of the Bestival, you have to take the ferry . The ferry is full of happy festival lovers who are ready to take part in the fantastic music party. After you arrive at the campsite, you can put your tent up. There people talk with each other openly. They are not that cold like those you meet in your everyday life.
The festival lasts for four days. During that time you forget all your worries and problems, just like living in a dream. And it is really hard for you to come back to "reality" after that.
It seems that it is this kind of music event that makes people gather together. It gives people a real sense of unity. I took part in the Bestival with my friends the year before last. It was so exciting and we all lost ourselves in the beautiful music. We are family sung by Sister Sledge was my favorite. I'm really looking forward to joining in it for a second time. [/INST] question: Where do people enjoy the music party at the Bestival? | options: A: On the island B: On the ferry C: In the hotel D: On the sea | answer: A </s> |
<s>[INST] context: A young woman was driving through the lonely countryside. It was dark and rainy. Suddenly she saw an old woman by the side of the road, holding up her hand as if she wanted a lift .
"I can't leave her out in this weather," the young woman said to herself. She stopped the car and opened the door.
"Do you want a lift?" she asked. The old woman nodded and climbed into the car. After a while, she said to the old woman, "Have you been waiting a long time?" The old woman shook her head. "Strange!" thought the woman. She tried again. "Bad weather for the time of year," she said. The old woman nodded. Then the young woman noticed the old woman's hands, which were large and hairy . Suddenly she realized that "she" was a man! She was frightened at first. Then she stopped the car. "I can't see out of the rear screen ,"she said. "Would you mind cleaning it for me?"
"The old woman" nodded and opened the door. As soon as "she" was out of the car, the frightened young woman drove off as fast as she could.
When she got to the next village, she stopped. She noticed "the old woman" had left "her" handbag behind. She picked it up and opened it. Inside was a gun [/INST] question: When the young woman talked with "her", "the old woman" only nodded or shook "her" head because "she" _ . | options: A: didn\'t want the young woman to hear "her" voice B: didn't want to trouble the young woman any more C: was so tired that "she" didn\'t want to talk with her D: wondered if the young woman had seen "her" hands | answer: A </s> |
<s>[INST] context: When we talk about red packets, the most important question is "What are you going to do with it?" One thing you could do is to put your money in the bank.
Maybe you don't know, some students in Hubei began to use the Xiaogui Dangjia bank card this year. This is a card for children. It is from China Minsheng Bank in Wuhan.
Wang Ming is a 14-year-old junior student in Wuhan. He said "All my pocket money has a place to go now. I can pay my own school fees ."
Zhu Yu, a manager of Minsheng Bank, said that they knew lots of students who didn't know how to use their money. So they wanted them to know how to use it carefully. Parents worry that children don't know how to take care of the money by themselves. Shen qiangqiang's mother like the card very much. Shen was asking his mother for a computer for a long time, but his mother didn't buy it for him. She said, "We want him to use his card to save money for the computer. If we buy everything he asks for, he will think money comes too easily, and he won't work hard for it."
Today, there are many different kinds of bank cards. They are from different banks. People put their money in them. Then they can use their money at any time. People can do many things with bank cards. They can wash cars, go shopping, eat delicious food and travel to other places with the money in their bank cards.
The most important thing is not "How much did you get?" It is necessary for everyone to learn how to save your money and use your money correctly. [/INST] question: In Wuhan, Xiaogui Dangjia bank card is for _ . | options: A: some teachers B: some parents C: some students D: some workers | answer: C </s> |
<s>[INST] context: Cervical factor infertility can be due to abnormal or deficient mucus ... William Gynae 1st/ed p 460
i. Infection
ii. Prior cervical surgery
iii. Use of antiestrogens (e.g. clomiphene citrate) for ovulation induction (so clomiphene is a cause of cervical factor
infertility rather than management)
iv. Sperm antibodies
The treatment of cervical factor thus depends on the cause:
• If it is due to chronic cervicitis/infection - Treatment of infection by antibiotics is the cure.
• If is due to decreased mucus volume - Treatment includes short term supplementation with exogenous estrogen like ethinyl estradiol and use of mucolytic expectorant like guaifenesin. However, their value has not been confirmed.
• If it is due to antisperm antibodies. Treatment options include:
– Use of condom or diaphragm as a barrier method for 3 months. During this period, the antibodies will disappear and conception may occur then.
– Corticosteroids given to female partner can also help in getting rid of these antibodies.
– Intrauterine insemination at the time of ovulation (most acceptable method for cervical factor infertility) or GIFT (Gamete intrafallopian transfer) are very useful techniques in such cases.
• IUI is the best method for treating cervical factor infertility and unexplained infertility. So many clinicians forgo cervical mucus testing and proceed directly to IUI treatment in absence of tubal disease. [/INST] question: A patient treated for infertility with clomiphene citrate presents with sudden onset of abdominal pain and distension with ascites, the probable cause is: | options: A: Uterine rupture B: Ectopic pregnancy rupture C: Multifetal pregnancy D: Hyperstimulation syndrome | answer: D </s> |
<s>[INST] context: There are three airports in New York. When you arrive at one of them, you can take a bus or taxi to any place in New York.
Public transport . In New York there's a good bus and subway service. If you are planning to use the subway a lot, you should buy a subway ticket for ten journeys because it's cheaper. But you don't have to use public transport, because there are lots of places you can go to on foot, like The Empire State Building , 5thAvenue and Central Park. The New York taxis are a part of the city experience , so you should take at least one taxi during your visit!
Hotels. There are lots of good hotels in New York. The best is _ on 5thAvenue but you don't have to pay a lot to stay in the city; there are lots of small hotels.
Eating out. There are many kinds of food in New York and you shouldn't eat at McDonalds every day. There are good restaurants in Little Italy and Chinatown, for example.
Shopping in New York is fun. There are big shops on 5thAvenue. They are open seven days a week. But be careful when you look at the prices; you have to pay a special 8% tax on everything you buy in New York.
Places to see. Finally, there are a lot of places to see in New York -- Times Square, the Statue of Liberty. And you shouldn't go home without climbing the Statue of Liberty. [/INST] question: "The Plaza" here is the name of _ . | options: A: a restaurant B: a hotel C: an airport D: a shop | answer: B </s> |
<s>[INST] context: Oral hypoglycemic agents Enhance insulin secretion Sulfonylureas ( K-ATP channel blockers )I - TolbutamideSafer in elderly & those prone to hypoglycemia, Controls postprandial hyperglycemia II - Glibenclamide, Glipizide, Gliclazide, GlimepiridePotent drugs with lower incidence of hypoglycemic attacks Meglitinide analogues Repaglinide, NateglinideStimulates insulin secretion & limits post prandial hypoglycaemiaGLP-1 receptor agonists Exenatide, Liraglutide Lowers post prandial hypoglycaemia , fasting blood glucose , HbA1c and body weight Produces anorectic effect DPP 4 inhibitors Sitagliptin, Vida gliptin, Saxagliptin, Alogliptin, LinagliptinBoosts postprandial insulin release, decreases glucagon secretion, lowers meal time & fasting blood glucose Overcome insulin resistanceBiguanide ( AMP-K activator )Metformin Suppresses hepatic gluconeogenesis, enhances insulin-mediated glucose uptake in skeletal muscle & fat, promotes peripheral glucose utilization Thiazolidinediones ( PPARg activator )Pioglitazone, Rosiglitazone, Troglitazone Suppresses hepatic gluconeogenesis, an activator of genes regulating fatty acid metabolism & lipogenesis in adipose tissue, lowers HbA1c and insulin levels Miscellaneous drugsa-glucosidase inhibitors Acarbose , Voglibose , Miglitol Reduces post prandial glycemia , lowers HbA1C levels Amylin analogue Pramlintide Delay gastric emptying, retard glucose absorption & promotes satiety Dopamine D2 receptor agonist Bromocriptine Suppresses glycemic peak, reduce body weight SGLT - 2 inhibitor Dapagliflozin, CanagliflozinProduces round the clock glucosuria, lowers blood glucose levels [/INST] question: The antidiabetic drug with anorectic effect is | options: A: Liraglutide B: Gliclazide C: Acarbose D: Chlorpropamide | answer: A </s> |
<s>[INST] context: Last year we visited prefix = st1 /Stratford, the place where Shakespeare was born on the 23rd of April, 1564.
Stratford is a very interesting town, right in the center of England. The countryside aroundStratfordis pleasant, with its beautiful woods, green fields and quiet rivers.
The first place we visited was the house in the center of Stratfordwhere Shakespeare was born. We saw the small desk that Shakespeare sat at when he went to school. One of the things we liked best was the garden behind the house, because we could see there many of the flowers, trees and plants that Shakespeare wrote about in his plays.
After we had visited Shakespeare's birthplace, we went to see the church where he was buried.
We had lunch in a very old hotel that was probably there in Shakespeare's time. Every room of the hotel had the name of one of Shakespeare's plays on the door--the "Hamlet" room, the "Romeo and Juliet" room, and so on.
After lunch we walked across the fields to the old cottage, about a mile out of Stratford, where Shakespeare spent most of his married life. The cottage is just as it was in Shakespeare's day. We saw the chairs where Shakespeare perhaps sat and thought about ideas for new plays, and we saw the plates from which he probably ate his dinner.
When we got back to our hotel that evening, we were tired, but we had enjoyed a wonderful day. [/INST] question: Stratfordis _ . | options: A: a church B: in the middle of England C: a very large city D: a small village | answer: B </s> |
<s>[INST] context: Prepare: Plan ahead and think about what you are going to say. In the words of Mark Twain, it usually takes you more than three weeks to prepare for it.
Know your subject: Always make sure that you know the subject and have background information at hand for question time.
Know you audience: Find out who you will be addressing so that you can tailor your comments accordingly.
Make a point: Keep your speech short and brief and have a few clear points that you need to convey .
Practice: Never learn your speech by heart as your speech will become stilted, but do practice it a few times in front of the mirror, your parents or your dog.
Eye contact: If the thought of looking into a sea of faces scares you, adjust your gaze regularly at different points in the room to create the same effect.
First impressions: Your first impression is important when making a public presentation. Find out about dress codes at the place so that you look your best and, if possible, check the microphone beforehand to ensure you know how to use it.
Get help: If public presentations are a major part of your life, read up on the art of speech---writing and delivery to improve your skills. [/INST] question: The advice benefits _ . | options: A: teachers B: actors C: speechmakers D: spokesmen | answer: B </s> |
<s>[INST] context: First lady Michelle Obama turns 50 on Friday, Jan. 17, 2014.
Michelle Obama has spent the first half-century of her life breaking barriers and checking off a series of firsts. Now, as she reaches her milestone birthday Friday, the nation will be watching to see in what other areas she will leave her mark.
Five years after moving into the White House, and without a re-election campaign to worry about, she has more room to relax in her role and, political watchers say, possibly become more vocal on political issues in the three years left in office.
So far, critics have complained about Michelle's silence on issues where they expected to hear her voice: Last year, at the start of her husband's second term, she disappointed advocates for tighter gun-control measures after she failed to push harder on the issue in response to the massacre at Sandy Hook Elementary School in Newtown, Conn. She also disappointed some feminists who wanted her to defend their causes instead of falling back on her self-described role as the nation's "mom-in-chief." Nor did she handle racial issues during her second term, as some had expected.
"The most important thing to remember is, whether you are black, white or Hispanic, you're the first lady and the president of all the people in the United States. That's a huge melting pot, so to reinforce that she's African American over anything else would not be wise," said Anita McBride, who directs programming and national conferences on the legacies of America's first ladies and their historical influence at American University.
Valerie Jarrett, a top White House adviser and a close friend of the Obamas, said the first lady doesn't want to " _ "
"She really wants to have a maximum impact and to do that in fewer areas," Jarrett told the Associated Press. "That, she said, "is better than trying to take on every single possible cause."
But Robert Watson, a Lynn University professor, said he expects Obama to "go a little harder at issues" over the next several years. "Second-term first ladies usually feel more at ease to speak more forcefully about issues close to their heart," he said.
Myra Gutin, a Ryder University communications professor and frequent lecturer on first ladies, said she expects Obama to continue making both of them a priority in her remaining years in the White House, given their success. Michelle launched the "Let's Move" campaign in 2010. It in particular has gained widespread support, ranging from the National Football League to the Sesame Street franchise , which even gave permission to the produce industry to use its licensed characters for free on fruits and vegetables.
"There's no such thing as a traditional first lady, not anymore in this technology-filled world. Is Mrs. Obama cutting edge? Is she an activist? No. As first ladies go, I think she's been politically careful because she does not want there to be a major flare-up that would require her husband to use his political capital to clean up," she said. "But she's not exactly just sitting in the White House pouring tea and having receptions, either." [/INST] question: Critics were disappointed with Michelle because _ . | options: A: she didn't put gun-control measures into effect B: she failed some feminists to stand out to be a career woman C: she didn't solve some racial problems D: she failed to voice her opinion on some issues | answer: D </s> |
<s>[INST] context: Diagnosis here is Stage 1C ovarian cancer, according to FIGO staging The tumour is limited to one or both ovaries, with any of the following: The ovary capsule is ruptured The tumour is detected on the ovary surface Positive malignant cells are detected in the ascites or peritoneal washings Treatment of Stage 1C (HIGH RISK STAGE 1 Disease) is adjuvant chemotherapy following Comprehensive surgical staging (involves hysterectomy + BSO) MANAGEMENT OF OVARIAN EPITHELIAL CANCER EARLY Low risk Stage 1A, 1B, low grade Surgical staging High risk Stage 1C, high grade Surgical staging + adjuvant chemotherapy ADVANCED Stage II, III, IV Maximal cytoreduction + adjuvant chemotherapy STEPS OF COMPREHENSIVE SURGICAL STAGING Veical midline incision Ascitic fluid for cytology If no ascites : take peritoneal washings Biopsy of suspicious lesions and diaphragm Supracolic omentectomy Retroperitoneal lymph node evaluation IMPOANT POINTS Maximal cytoreduction: means removal of entire pelvic tumor + resection of metastasis Optimal debulking: less than 1 cm of residual lesion Feility sparing surgery (unilateral salpingo-oophorectomy): Stage 1A with low grade, Bordeline tumors Neo adjuvant chemotherapy: Stage III and IV with massive ascites, massive pleural effusion, unresectable tumor. iT increases chances of optimal debulking [/INST] question: A 60 yr old woman came to OPD with distended abdomen and postmenopausal bleeding. Imaging suggests bilateral ovarian complex masses with a CA 125 value of 1500. A comprehensive surgical staging is planned. Per operatively, bilateral ovarian masses are seen with surface involvement and ascites. There is no pelvic or extrapelvic extension of tumor or lymph node involvement. What is the appropriate treatment? | options: A: Maximal cytoreduction surgery B: Hysterectomy + Bilateral salpingo-oophorectomy C: Proceed with surgical staging with hysterectomy + Bilateral salpingo-oophorectomy followed by adjuvant chemotherapy D: Bilateral salpingo-oophorectomy followed by adjuvant chemoradiation | answer: C </s> |
<s>[INST] context: When visiting New York City with your kids,there are many things to do with kids that will entertain their spirits and feed their minds.
The Whispering Gallery
Make your way to the Whispering Gallery. The Whispering Room's architecture allows for a phenomenon that usually makes people laugh. Once inside the gallery,place one person facing the corner at one end of the room and then place another person facing the corner at the opposite end. Ask one of the participants to whisper a phrase or a quick sentence or two and the person on the opposite end will be able to hear every word that was said.
E. 42nd St.
2127715322
grandcentralterminal. com
The American Museum of Natural History
The American Museum of Natural History was founded in 1869. In addition to its impressive exhibits,permanent attractions bring the cool factor home to kids. They can enter the Fossil Halls and see the impressive dinosaur skeletons .And the Milstein Hall of Ocean Life educates kids about the fragility of the Ocean
Central Park West at 79th St.
2127695606
amnh. org
the Scholastic Store
Most parents want their children to read,and moreover,to enjoy reading. Scholastic helps to make that wish a reality by publishing interesting,well-written stories that are popular with children. With such classics as"Clifford the Big Red Dog","The Magic School Bus,"and"Harry Potter,"the Scholastic Store will delight your children.
557 Broadway
2123436100
scholastic. com
Ellen's Stardust Diner
The restaurant is a place where each person in your family can find something to eat. Arugula salads,grilled cheese,burgers and meatloaf are all on this varied menu. A hall of beauty queens,a drive-in theatre and wait staff that sing to you can add to this unique dining experience.
1650 Broadway,corner of 51st St.
2129565151
ellensstardustdiner. com [/INST] question: Which of the following websites helps kids learn about animals? | options: A: ettensstardustdiner. com B: grandcentralterminal. com C: amnh. org D: scholastic. com | answer: C </s> |
<s>[INST] context: Acute viral myocarditis, alcohol abuse, pregnancy., thyroid disease, cocaine use, and chronic uncontrolled tachycardia cause dilated cardiomyopathy- Harrison 17th/l481
Restrictive Cardiomyopathies (RCMs) - Harrison 17th/1485-86
The hallmark ofthe restrictive cardiomyopathies (RCMs) is abnormal diastolic function ; the ventricular wails are excessively rigid and impede ventricular filling. In late stages systolic function is also impaired.
Myocardial fibrosis- livpertropby. or infiltration due to a variety of causes is responsible. Myocardial involvement with amyloid1 is a common cause of secondary restrictive cardiomyopathy although restriction is also seen in the transplanted heart, in hemochromatosis, glycogen depositiong, endomyocardial fibrosis, sarcoidosis , hypereosinopbillc disease., and scleroderma; following mediastinal irradiation; and in neoplastic infiltration and myocardial fibrosis of diverse causes.
In many of these conditions, particularly those with substantial concomitant endocardial involvement, partial obliteration of the ventricular cavity by fibrous tissue and thrombus contributes to the abnormally increased resistance to ventricular filling.
Thromboembolic complications are frequent in such patients
The inability" of the ventricles to fill limits cardiac output and raises filling pressures; thus, exercise intolerance and dyspnea are usually prominent. As a result of persistently elevated systemic venous pressure, these patients commonly have dependent edema, ascites, and an enlarged, tender, and often pulsatile liver .
The jugular venous pressure is elevated and does not fall normally (or may rise) with inspiration (KussmauTssignf [/INST] question: Causes of restrictive cardiomyopathy are-a) amyloidb) sarcoidosisc) Viral myopathyd) Alcohole) Storage disease | options: A: abe B: bcd C: cde D: acd | answer: A </s> |
<s>[INST] context: In northern Scotland there is a long, deep lake called Loch Ness. More than 200 meters deep, it is the largest lake in the UK. People say a big monster lives in its dark, cold waters. It weighs more than 1,000 kilos and is at least ten meters long. Some people say it has a head like a horse. Others say it looks like a snake. Many people travel to Loch Ness to look for this strange monster, but only a few people have seen it. At least, they say they have seen it.
The Loch Ness Monster is a famous legend . The first story about a monster in Loch Ness was told over 500 years ago, but the legend of the monster spread widely only in the twenties century. In 1933, a husband and wife reported that they saw a big monster in Loch Ness. Several people have taken photos, but at least one of them was a hoax . During the 1960s, a team was formed to look for the monster. They took many photos and made movies, but they were never able to find a monster.
There is no real fact that a monster lives in Loch Ness, but there is also no fact that one doesn't live. One thing is true about Loch Ness: there are a lot of tourists there. [/INST] question: In northern _ there is a long, deep lake called Loch Ness. | options: A: Scotland B: HongKong C: Rome D: Paris | answer: A </s> |
<s>[INST] context: What do you use to get around town? A car? A bike? Your feet ? perhaps you should try a segway!
The Segway is perfect for short journeys. It's an electric vehicle that consists of a platform between two wheels, with a pole that connects the platform to the handlebars. To ride it , you step up onto the platform, and control the Segway by moving your body. Lean forwards to go faster, and back-wards to slow down.
On older models, direction was controlled by a twist grip on the left handlebar. This varies the speeds between the two motors, and a decrease in the speed of the left wheel would turn the Segway to the left . With newer models you simply lean to the left or right. Meanwhile, a gyroscope detects your movements and prevents the machine from falling over. The Segway has a maximum speed of 19 km per hour and a range of about 38 km. after that, you need to plug it and recharge the battery.
Segways are used for a variety of purposes. People with mobility problems can now enjoy walks in the country with their friends and family. Some golfers see them as an alternative to the golf cart . And dog owners now have an easier way to take the dog to the park. A few police forces use Segways, too. They allow officers to move quickly while maintaining contact with the public. They're also becoming a common sight on airport . However, the most popular use is in tourism , particularly for city tours . Visit any major tourist city in summer, sit outside a cafe for a while and there's a good chance you'll see a group of tourists passing on Segways. [/INST] question: How do you turn to the left on a Segway of the new model? | options: A: Lean to the left B: Adjust the twist grip C: Press the left bar D: Control the gyroscope | answer: A </s> |
<s>[INST] context: Jesse McCartney began entertaining and delighting audiences at a very early age in off-Broadway stage shows including Oliver, A Christmas Carol, and Annie Get Your Gun. At the age of seven, he began a national tour the stage musical show of The King and I. 1998 brought his big chance in television with the role of Adam Chandler, Jr. on All My Children. McCartney stayed with the show for the next three years and won several awards for his role of Chandler.
In 1999 he showed great interest in music, when he auditioned for and won a spot in a boy band called Dream Street. Sales of the group's album once reached up to 300,000 copies. Shortly after the album _ , they toured around the USA with Britney Spears before the band broke up in 2002.His first band was called the Sugar Beats, and in 2003 McCartney partnered with their producer Sherry Kondor to launch his solo career. The song Beautiful Soul became the title track for McCartney's first solo album. Following the great success of his album, it took McCartney one and a half year to make his new one, Right Here You Want Me, which, according to McCartney himself, has had more personal experiences and thoughts.
McCartney never gave up acting and appeared the films The Pirates of Central Park and The Strange Legacy of Cameron Cruz. In 2004 he successfully played the role of Brandin Westerly on the TV series Summerland. He has also combined music and film, contributing songs to films.
Born April 9, 1987, Jesse is the oldest of three children. His parents were actors in New York City. His sister Lea Joyce was born in 1991 and brother Timmy, with whom Jesse is very close, came along in 1996.He graduated from Ardsley High School (New York) in 2005, where he was a junior baseball pitcher . Jesse's best friend is former band mate Greg Raposo. [/INST] question: Which of the following is NOT mentioned of Jesse McCartney? | options: A: education B: family C: success in music D: tours abroad | answer: D </s> |
<s>[INST] context: "Children need more geography field trips. Schools should organize geography field trips to stop pupils from sitting before computer screens for a long time. And children should be encouraged to see the natural world and study geography," says Michael Palin.
The famous actor and writer, Michael Palin, made the comments days after a study showed that pupils in the UK were less likely to take part in science field trips than in most other developed countries.
The study found that 13% of schools in the UK failed to take children out of the classroom regularly.
Mr. Palin said that field trips were an important part of geography and that he was interested in geography because he had a good geography teacher and he had many opportunities to "get out of the school building".
In an interview, Mr. Palin said, "It was important for children to see things for themselves and learn about the rest of the world. You have to show them a mountain, show them a factory, show them a power station."
Mr. Palin had been to the North and South Poles, the Himalayas , the Sahara and Eastern Europe.
"Geography is about the study of the earth. It is a _ subject," he said. "It's related to everything we do: what we eat, what transport we take to work, where we live, what houses are made of, and so on."
He said children needed to get basic geography knowledge first and that once they had the basic knowledge they could move on to deeper problems, such as population and pollution. "Today's children will need to deal with a lot of problems when they grow up. They have to learn geography today," he said. [/INST] question: The study showed that _ | options: A: about 10% of British schools didn't organize field trips regularly B: many British students were not interested in geography C: some geography teachers didn't do a good job D: students who studied geography seldom went out of the school building | answer: D </s> |
<s>[INST] context: Mrs Young was eighty. Her husband died when she was fifty - three and he left her an old car he had had for six years. She learned to drive and loved very much. She liked driving very fast, and was proud of the fact that she had never been caught for a driving offence .
Then one day she nearly lost her record . A police car followed her, and the policeman in it saw her pass a red light without stopping and she was taken before a judge. The man looked at her and said that she was too old to drive a car, and the reason why she had not stopped at the red light was most probably that her eyes had become weak with old age, so that she had simply not seen it.
When the judge had finished what he was saying, Mrs Young opened her handbag she was carrying and took out her sewing. Without saying a word, she chose a needle with a very small eye , and threaded it at her first try.
When she had finished it, she took the thread out of the needle again and handed both the needle and the thread to the judge, saying, "Now it's your turn. I suppose you drive a car, and that your eyesight is good."
The judge took the needle and tried to thread it. After trying six times, he had still not done it. At last he had to set the old woman free and her record remained unbroken. [/INST] question: Mrs Young's car was _ years old. | options: A: 16 B: 33 C: 40 D: 53 | answer: B </s> |
<s>[INST] context: "Am I my brother's keeper?" The question comes from the Bible . In the Bible, Cain kills his brother Abel. When God asks Cain where Abel is, he replies, "I don't know. Am I my brother's keeper?" by which he means, "Am I responsible for my brother--his safety and health?" The answer, of course, is "Yes, you are."
This sense of responsibility for others is basic to all good societies. And also it is basic to what we call "civil society". China is now working on building a civil society and the high schools in Shanghai want students to take part in _ through volunteering. They are supposed to do sixty class hours of volunteer work before graduation. This is something new in China, but it is not new in other countries.
In the Canadian province of Ontario, high school students are required to do forty hours of volunteering. In some American states, the volunteering requirement is one hundred hours. These students spend about an hour a week during the school year and summer vacations, helping the poor, the sick and the old. They also teach young children to read and help to clean up the environment. And studies have shown that this volunteering experience influences students a lot after graduation.
Some of you may be thinking, "Gee, sixty class hours is a lot. How can I find the time?" In fact, if you finish it in three years, you only need to do the work about three class hours a month. And the time is well spent if it helps you realize that "being your brother's keeper" makes you a better person and makes society a better place for everyone. [/INST] question: A Shanghai high school student should finish _ class hours of volunteer work before graduation. | options: A: thirty B: forty C: sixty D: one hundred | answer: C </s> |
<s>[INST] context: For a long time, humans have used technology to study the world around us, and Mars is the latest place we're using machines to explore. Besides the earth, the "red planet" is seen, as the one place in our solar system most likely to have life.
Early last month, the first American robot, Spirit, landed on Mars without any problem. Opportunity, the second robot, landed on the planet more than a week ago. Scientists are very excited about these machines' safe landing on Mars. It means that now we have an excellent chance to look for water and other signs of life. So far, the robots have found some stones that could show Mars was once a wet and warm planet.
But the trips made by Spirit and Opportunity were dangerous. Mars is often called the "death planet", because in the past its environment has been unfriendly to the robot explorers. Before Spirit and Opportunity, nearly forty spaceships had been sent to Mars since the 1960s. Two-thirds of them failed. The first spaceship, Korabl, sent in 1962 by Russia was among them. It broke apart near the earth. [/INST] question: For a long time humans think _ . | options: A: they can surely find life on Mars B: there may be life on Mars C: it's too late for them to explore Mars now D: Mars is the only planet that has life on it | answer: B </s> |
<s>[INST] context: Accidents happen almost every day. Some accidents are not serious and some are. We read about such accidents nearly every day in the newspapers. It is wrong for people to think that accidents take place only on the roads or highways, or even at work places. Home accidents are just as common. Because very few home accidents are reported, people come to think that there are few accidents which happen in homes.
There have been many cases where people fall to their deaths from high rise flats. Children often fall over while coming down the stairs. Old people may slip on wet floors if they are not careful.
Nowadays there are a lot of modern electrical appliances such as rice cookers which make life easy for the modern house wives. These appliances can kill if they are not used in the proper way. Gas stoves used for cooking are also dangerous if they are not properly used. They may cause burns or, in more serious cases, even fires.
But all such accidents can be stopped if we are careful and follow simple rules of safety. For example, it is unwise for people to try repairing their own electrical appliances if they do not know how to. It is safer to get them repaired by an electrician . [/INST] question: Accidents take place _ . | options: A: mostly in homes B: mostly on roads and highways C: mostly in factories D: almost everywhere | answer: D </s> |
<s>[INST] context: "Cool" is a word with many meanings. Its old meaning is used to express a temperature that is a little bit cold. As the world changes, the word has many different meanings.
"Cool" can be used to _ feelings of interest in almost anything. When you see a famous car in the street, maybe you will say "It's cool." You may think, "He's so cool," when you see your favorite footballer.
We all maximize the meaning of "cool". You can use it instead of many words such as "new" or "surprising". Here's an interesting story we can use to show the way the word is used. A teacher asked her students to write about the waterfall. On one student's paper was just the one sentence, "It's so cool". Maybe he thought it was the best way to show what he saw and felt.
But the story also shows a scarcity of words, it seems that some people have no words to show the same meaning without "cool" . Can you think of many other words that make your life as colorful as the word "cool"? Yes, I can. And I think they are also very cool. [/INST] question: We know that the word "cool" has _ . | options: A: only one meaning B: the same meaning C: many different meanings D: two meanings | answer: C </s> |
<s>[INST] context: Hyperventilation syndrome * Hyperventilation syndrome (HVS) represents a relatively common emergency depament (ED) presentation that is readily recognized by most clinicians. * The underlying patho-physiology has not been clearly elucidated. * HVS is a condition in which minute ventilation exceeds metabolic demands, resulting in hemodynamic and chemical changes that produce characteristic dysphoric symptoms * Inducing a drop in PaCO, through voluntary hyperventilation reproduces these symptoms. * Many patients with HVS do not manifest low PaCO, during attacks. Pharmacologic Therapy * Benzodiazepines are useful in the treatment of hyperventilation resulting from anxiety and panic attacks. * By binding to specific receptor sites, these agents appear to potentiate the effects of gamma-aminobutyric acid (GABA) and to facilitate inhibitory GABA neurotransmission and the actions of other inhibitory transmitters. * Alprazolam (xanax) is indicated for treatment of anxiety and management of panic attacks. * Lorazepam (ativan) is a sedative-hypnotic of the benzodiazepine class that has a sho time to onset of effect and a relatively long half-life. ref : harrisons 21st ed [/INST] question: hyperventilation may lead to ? | options: A: tetany B: respiratory alkalosis C: metabolic acidosis D: metabolic alkalosis | answer: A </s> |
<s>[INST] context: Public schools in Washington, D.C. provide students with musical instruments for free. When something goes wrong with an instrument, Charles West and Larry Jernigan do the repairs. Both men approach their work with a passion . For them, it's important that students have a joyful experience with music.
The two have worked together for almost 20 years. This year alone, they've fixed about 450 instruments. Both men are musicians and music lovers, so learning to do repairs came naturally.
"I have been a musician all my life." says West. "I played in an orchestra here in the city. I majored in music in college. I played in an army band."
Jernigan's musical interests are varied. "I was formerly trained in the piano and guitar. The alto sax, and the flute, I picked up while working here."
In addition to fixing instruments, the two also go to schools to instruct teachers and students on how to make minor repairs on their own.
West believes if children start early and stay concerned with music, it enriches other areas of their lives. "I see that in other kids. I see it in myself. I have seen it hundreds of times and it works," he says. "They learn teamwork. They learn patience and respect."
But West has concerns about the future of music in the electronic age.
"This instant age has taken away from the sit-down, the patience. And to learn to play an instrument, it takes patience, it takes diligence, it takes time."
Being able to enjoy music on the job is one of the benefits of the job. Both men agree their best rewards are the students' performances. [/INST] question: What's the job of West and Jernigan at school? | options: A: Teaching music B: Writing music C: Making musical instruments D: Repairing musical instruments | answer: D </s> |
<s>[INST] context: How to save money to visit Shanghai Disneyland?
The "happiest place on earth" is a top destination on many families' bucket lists. But taking a vacation to Disney World can be difficult to do on a budget. There are some considerations that you can make to reduce the cost of your Disney World vacation.
1. Buy Souvenirs in Advance
Disney has influenced practically every industry, which makes it easy to find Disney items anywhere, from Walmart, Target, and your local grocery store to department stores and Amazon. You can save a lot of money by purchasing items before your trip at these less-expensive places than at Disneyland.
2. Make an Autograph Book
An autograph book is seen as a must-have by many Disneyland enthusiasts and is a memory you can take home with you. These books can cost anywhere from $7.95 to $19.95 at the Disney Store and up to $30 for the latest-and-greatest autograph book at Disneyland, such as the park's 60th anniversary edition. Other choices can get the job done for under $5. For example, you can buy a small photo album; cute pads or notebooks.
3. Eat Breakfast Before You Arrive
Breakfast is almost as pricey as lunch or dinner if you eat inside the Disneyland parks. If you have a hotel with a free breakfast, take advantage of it. If you want to eat out, eat at a local restaurant that is inexpensive or has a kids' menu, such as McDonald's which is close to the park.
4. Take Advantage of Discounts Offered to Special Groups
Disney offers a wide variety of discounts, including for military service members, college students, teachers, and youth groups. If you think you might qualify for a special discount or group rate, call the Disneyland Resort to book tickets. [/INST] question: It may take you more money to buy souvenirs at _ . | options: A: Disneyland B: Department stores C: Walmart D: Amazon | answer: A </s> |
<s>[INST] context: Nelaton's line :
With the hip in 90 degree of flexion, a line joining the ASIS and ischial tuberosity passes through the tip of the greater trochanter on that side.
In cases of supratrochanteric shortening the trochanter will be proximal to this line.
Shoemaker's line :
With the patient lying supine, the line joining ASIS and tip of the greater trochanter is extended on the side of the abdomen on both sides.
Normally these lines meet in the middle above the umblicus.
In case one of the greater trochanters has migrated proximally the lines will meet in the opposite side of the abdomen and below the umblicus.
Chiene's line :
With the patient lying supine, lines are drawn joining the two ASIS and the two greater trochanters.
Normally these make two parallel lines. In case one of the trochanters has moved proximally the lines will converge on that side.
Perkin's line :
When the congenital Dislocation of hip is mild in nature, the perkins lines are drawn to detect it.
A horizontal line is drawn through the triradiate cartilage and a vertical line is drawn down from the outer edge of the acetabulum on both sides.
The upper femoral epiphyses normally lies medial to the vertical line and below the horizontal line.
But in congenital dislocation of hip the epiphyses will lie on the outer aspect of the vertical line and above the horizontal line.
Bryants triangle :
The patient lies supine.
The tips of the greater trochanter and ASIS on both sides are marked.
A perpendicular is dropped from each ASIS on to the bed. From the tip of the greater trochanter, another perpendicular is dropped on to the first one. The tips of the greater trochanter are joined to the ASIS on the respective side. This forms a triangle ABC.
The side BC of the triangle measures supra trochanteric shortening of the hip. [/INST] question: The line joining ant. sup iliac spine to ischial tuberosity and passes a greater trochanter - | options: A: Nelaton's line B: Showmakers line C: Chiene's D: Perkins line | answer: A </s> |
<s>[INST] context: Once a boy often made trouble. His mother gave him many nails . She told him to hammer(,)one in the garden fence every time he lost his patience and fought with someone. The first day he hammered 27 nails. In the following weeks he learned how to control himself better and the number of nails hammered became smaller and smaller. He learned it was easier to control himself than to hammer nails.
The day finally came when he didn't hammer any nails. He went to tell his mother about it. Then his mother told him to pull off a nail from the fence each time he didn't lose his patience. After some days he told his mother that all the nails had been pulled off, so she took him to the fence and said to him, "You've behaved well, but look at all the holes in the fence. The fence will never be again like it was before. When you fight with someone, you leave wounds in him like these. The trouble may be over, but the wounds will always be there."
So, learn to control yourself before you hammer the nail in the fence. Try not to leave any holes in your past. [/INST] question: Losing control may bring you _ . | options: A: good luck B: trouble C: nails D: a hammer | answer: B </s> |
<s>[INST] context: This patient appears to have primary syphilis, as evidenced by a penile chancre that was not tender. One ofthe differences between syphilis and herpes simplex virus (HSV) is that an HSV lesion is excruciatingly painful. Treponemal organisms may be seen microscopically in the lesion if the lesion is scraped. If not treated, the chancre will disappear and the patient will be asymptomatic until he/she exhibits the signs/symptoms of secondary syphilis, which include a disseminated rash and systemic involvement such as meningitis, hepatitis, or nephritis. There are two kinds of tests for the detection of syphilis antibodies: non- specific tests such as the RPR and VORL, and specific tests such as the FT A, TPHA (T pallidum hemagglutination test), and the MHTP (microhemagglutination-T pallidum). The difference is that the nonspecific tests use a cross- reactive antigen known as cardiolipin, while the specific tests use a T pallidum antigen. Although the nonspecific tests are sensitive, they lack specificity and often cross- react in patients who have diabetes, hepatitis, or infectious mononucleosis, or who are pregnant. Some patients, especially those with autoimmune diseases, will have both nonspecific (RPR) and specific tests (FTA) positive even if they do not have syphilis. Resolution of such a situation can be done by molecular methods for T pallidum, such as PCR, or by the immobilization test using live spirochetes and the patient's serum. In the TPI test, the spirochetes will die in the presence of specific antibody. [/INST] question: VDRL test performed on the patient having painless penile ulcer for 2 week is reactive at a dilution of 1:4 (4dilutions). The patient also repos to you that he has recently been diagnosed with hepatitis A which one of the following actions would be most appropriate? | options: A: Order a confirmatory test such as FTA test B: Order a rapid plasma region (RPR) test C: Perform a spinal tap to rule out CNS syphilis D: Repeat the VDRL test | answer: A </s> |
<s>[INST] context: When people are dirty, they take a bath or a shower. Animals don't have soap , but they do keep themselves clean. Many animals with hair, such as dogs and cats, keep themselves clean by licking their hair. They also use their teeth to pull out small dirty things from their hair. When they lick their hair, it is almost as if they are using a wet brush to clean themselves.
Birds take baths to stay clean. First they walk through water that is not deep. Next they beat their wings to dry themselves. Birds also take sand baths on the ground. It is thought that they do this to drive away parasites .
Even fish need cleaning. Fish have very little parasites that live in their mouths. Some fish live by eating these parasites off other fish. Such fish are called "cleaner fish". Larger fish will open their mouths so that the cleaner fish can get in to clean.
Some animals that live in groups clean each other, such as monkeys. They often clean one another. One monkey may clean an area that the other monkey can't reach. How interesting it is! [/INST] question: One way that birds keep clean is to _ . | options: A: open their mouths B: take sand baths C: beat their wings D: clean each other | answer: B </s> |
<s>[INST] context: Types of vagotomy
Highly selective vagotomy (HSV)
Vagotomy and drainage (V+D)
Vagotomy and antrectomy (V+A)
Vagotomy is a component of each of these procedures. It decreases the acid secretion by stopping cholinergic input into the stomach.
But since vagus nerve is also the motor supply of stomach and the antropyloroduodenal segment a truncal vagotomy leads to gastric stasis.
Gastric stasis is prevented by adding a drainage procedure to the truncal vagotomy (Vagotomy & drainage - V+ D).
Drainage procedure used are :
Gastrojejunostomy
Pyloroplasty
In Highly selective vagotomy (also known as parietal cell vagotomy or proximal gastric vagotomy) the vagal innervation to the antrum and pylorus (nerves of Latarjet) are preserved, only the vagal supply to the proximal two- thirds of the stomach (where essentially all the parietal cells are located) is cut.
This preserves gastric motility
Advantages
Technical simplicity & preservation of entire gastric reservoir capacity.
Lowest mortality and side effects
Minimal chances of dumping syndrome
Disadvantage
Recurrence rates are higher than V + D or V + A.
Vagotomy plus antrectomy
In this operation, a distal gastrectomy (about 50% of the stomach) is done. This removes almost all the gastrin-producing mucosa, thus acid reduction is maximum in this operation.
Advantages - lowest recurrence rate
Disadvantage - high mortality & morbidity [/INST] question: Nerves of latarjet are spared in | options: A: Highly selective vagotomy B: Vagotomy and antrectomy C: Vagotomy and Drainage D: truncal Vagotomy | answer: A </s> |
<s>[INST] context: What are the specific traits that will assist executives to climb the ladder of success? Opinions vary widely. Given almost equal qualifications and circumstances, some claim the success factor is largely a matter of luck--being in the right place at the right time. Others speak of an almost crazy devotion to work, combined with a degree of ruthlessness. One"expert" believes that it's undoubtedly a matter of how much education your mother had.
To make it big, executives must possess four basic skills:
First, drive . Business success takes an unusual amount of energy. A successful executive -- almost by definition--is a striver. He will get tense when he is not striving.
Second, people sense. Some say being able to judge people is more important than a high IQ. The skill can be instinctual , but in most cases it is painstakingly learned.
Third, communications ability. Different executives make themselves understood in different ways, Some transmit ideas best face to face; others are masters of the telephone call; still others are persuasive writers. One way or another, they all communicate clearly.
Fourth, calm under pressure. No businessman will get very far if he chokes up. [/INST] question: Some people claim that besides hard work, the success also requires_. | options: A: equal qualifications B: specific traits C: much education D: a degree of cruelty | answer: D </s> |
<s>[INST] context: In films, dads change from cruel men to loving souls. Here is a list of good and bad movies dads .Atticus Finch in To kill a Mockingbird
GOOD DAD:A man whose wife has died with a young family and a busy job as a lawyer, Gregory Peck's character in the 1962 film is one of the great heroes of American cinema Firm but fair he teaches his children respect and human decency .Harper Lee's novel gets a respectable transposition to film, thanks to Gregory Peck's perfect performance.
Jack Torrance in The Shining
BAD DAD: When Jack Torrance ,his wife ,Wendy ,and son, Danny ,escaped from the cold winter to the Overlook Hotel we know that Jack has hardly been a model father But when Jack becomes extremely angry and tries to murder his family with an axe, Danny used his intelligence to defeat him and left him to freeze to death.
George Bailey in It's a Wonderful life
GOOD DAD: James Stewart's character is a father-of-four who is saved from the edge of suicide and realizes his positive effect on others lives.Much of the film is unpleasant, with George shouting at his children as he faces financial problems. But finally the lovable father realizes the worth of his own life, the value of friendship and the importance of being a loving dad
Darth Vader in The Empire Strikes Back
BAD DAD: When the unfriendly cyborg told Luke Skywalker that he was his father ,the son's reaction says it all: "No! No!" It's hardly a joyful welcome to the family. For most of his son's life, Darth Vader has been an absent dad--and he has just cut off Luke's hand You can understand why Father's Day cards might not be available. [/INST] question: Who is Harper Lee? | options: A: An actor B: A novelist C: A movie director D: A translator | answer: B </s> |
<s>[INST] context: Call out. Call loud: "I'm ready! Come and find me!"
The snacks in the tool shed smell like the seaside.
They'll never find you in the salty dark,
But be careful that your feet aren't sticking out.
Wisher not to risk another shout.
The floor is cold. They'll probably be searching
The bushes near the swing. Whatever happens,
You mustn't sneeze when they come prowling in.
And here they are, whispering at the door;
You've never heard them so hushed before,
Don't breathe. Don't move. Stay dumb. Hide in your blindness.
They're moving closer, someone stumbles, mutters;
Their words and laughter scuffle, and they're gone.
But don't come out just yet; they'll try the lane
And then the greenhouse and back here again.
They must be thinking that you've very clever,
Getting more puzzled as they went away.
You legs are stiff, the cold bites through your coat;
The dark damp smell of sand moves in your throat.
It's time to let them know that you're the winner.
Push off the snacks. Uncurl and stretch. That's better!
Out of the shed and call to them: "I've caught you!"
The darkening garden watches. Nothing stirs.
The bushes hold their breath; the sun is gone.
Yes, here you are. But where are they who sought you?
---Vernon Scannell [/INST] question: Which part of the body is difficult to hide? | options: A: head B: hands C: legs D: feet | answer: D </s> |
<s>[INST] context: How to look good in a photo?
What should you do if you want to have a nice photo taken? Whether it's work or fun, the most important thing is lighting. If you get bad lighting, you will look bad, too. Know where the light is. You don't want it below you or above you, you want it to shine directly at you.
The key thing is no shadow. If you are being photographed outside, do it in the morning, or wait till the 2 o'clock shadow has passed. Also don't let pictures in the magazines stress you out--all the pictures are taken by great photographers. And all the faces have had pimples(, ) taken out by computers.
Tip your head and learn what angles work with your face; everyone is different. So you have to learn what suits you. You can practice in Photo Booth for as long as it is your turn, to learn what angles suit your face. Tip your neck to make it look longer, make eye contact with the camera. No one can look bad if they smile.
For long legs, point one leg into center of the frame and get the photographer to shoot looking up your body.
For just leg shots, lie upside down and raise legs in the air for the best angle. And your legs will look thinner and be in better shape.
Keep shoulders back.
Always have mouth slightly open, enough to put a penny between your lips, as this will make your lips look fuller.
Lower your eyes and then look up just as shutter is clicked for full eyes.
Delete any evidence of a less than perfect photogenic moment, everyone has off days. [/INST] question: If you want to look good in a photo, the light should be _ . | options: A: below you B: directly at you C: above you D: right behind you | answer: B </s> |
<s>[INST] context: Let Children Roam Free
Everyone agrees that playing outside keeps children thinner. The loss of opportunities for outdoor play is one of the main causes of childhood obesity. What is more remarkable is the growing evidence that children's mental health and emotional well-being are enhanced by contact with the outdoors, and that the restorative effect appears to be strongest in natural settings. Researchers are convinced of the depth of the connection between children's well-being and the environment, claiming that contact with nature may be as important to children as good nutrition and adequate sleep.
But now children seem to get less touch with outdoor activities. The root causes of the dramatic loss of children's freedom lie in changes to the very fabric of their lives over the last 30 years or so. The growth in road traffic, alongside poor town planning and shifts in the make-up and daily rhythms of families and communities, have left children with fewer outdoor places to go. These changes coincided with the "culture of fear": a generalized anxiety about all imaginary kinds of threats, even though children are statistically safer from harm now than at any point in human history.
These physical, economic and social changes and fears have been made use of by manufactures and advertisers, whose products and messages both reinforce the logic of keeping children virtual prisoners, and force us to compensate them in the only way our cash-rich, time-poor society seems to know: by spending money on them.
Government must bear some of the blame for keeping children prisoners indoor, through their promotion of planning policies that favour cars over communities and profit over people. The real planning crimes lie in housing companies occupying attractive parks and green spaces, and in town plans that force families to depend largely on their cars. There is no doubt that traffic danger, unlike stranger danger, is a real threat to children and a constant worry for parents.
Around 100 child pedestrians are killed every year, a figure that puts the UK near the bottom of Europe's child road safety league. It is no surprise that figures show a steady fall in children walking or cycling over the last twenty years, to the extent that while over 90% of children own a bicycle, just 2% cycle to school. Also, 30% of children aged eight to ten never play outside without an adult watching over them.
In a single generation, the "home habitat" of a typical eight-year-old----the area in which children are able to travel on their own- has shrunk to one-ninth of its former size. Health experts have even created a new word, "obesogenic", to describe those aspects of our lives that make us fat, and top of the list is the design of streets, towns and cities. [/INST] question: Playing outside is just as important as _ . | options: A: dieting to lose weight B: releasing emotions C: getting enough sleep D: exercising the mind | answer: C </s> |
<s>[INST] context: Clinical features like fever; night sweats and weight loss and X-ray finding of a mass in apical lobe with histopathological findings of caseous necrosis are highly suggestive of tuberculosis. The underlying process is type IV hypersensitivity, which is characterized by the presence of modified macrophages, lymphocytes & giant cells.
Schematic illustration of the events that give rise to the formation of granulomas in cell-mediated (type IV) hypersensitivity reactions.
Tuberculosis
Antigenic property :
Group specificity is due to polysaccharide while type specificity is due to a protein antigen.
Antibodies are not useful for diagnosis and immunity.
Pathogenicity:
Macrophages are the primary cells infected by M. tuberculosis.
M. tuberculosis replicated within the macrophages (phagosome) by blocking fusion of phagosome and Lysosome.
It is due to the escape of killing by macrophages and induction of type IV hypersensitivity.
Factors contributing to pathogenesis: Cord factor, Lipoarabinomannan, Complement system, M. tuberculosis heat shock proteins.
Risk of acquiring infection is determined mainly by exogenous factors while the risk of developing disease depends largely on endogenous factors
Most potent risk factor- HIV coinfection
Clinical Features [/INST] question: A 45-year old patient presented with fever, night sweats and weight loss. On X-ray, a mass was seen in the apical lobe. On histopathology, caseous necrosis was present. What is the name of the underlying process? | options: A: Enzymatic degeneration B: Acute decrease in blood supply C: Decreased supply of growth factor D: Hypersensitivity reaction with modified macrophages, lymphocytes and giant cells | answer: D </s> |
<s>[INST] context: ORIENTATION: in time, place and person; loss occurs in this sequence, recovery in reverse order Disorientation in delirium: Orientation is the normal state of (oneself and one's surrounding in terms of time, place and person. Stupor Twilight state Oneiroid state / Onirism An imprecise term for 1. State of decreased reactivity to stimuli. 2.Unresponsiveness with immobility 3. Mutism but retention of consciousness & often with open eyes that follows external objects. * It is disturbed consciousness with hallucinations. * It appears as waking dreams that portray desires, wishes or fears in a direct or symbolic way as being already fulfilled. * A transitory disturbance of consciousness during which many acts, sometimes very complicated may be performed without the subjects conscious volition and without retaining any remembrance of them. *Responsiveness as a rule only to some given complex, the rest of the personality being subordinated to, or as a rule, more or less completely submerged during the period of twilight state for example an epileptic patient, entirely unmindful of his natural surroundings, believed that he was walking around in Heaven; during the phase he was utterly unable to recall any part of his life. It is dream state, while one is awake, a waking dream. Delirium Acute reversible cognitive disorder with relatively global impairment, consisting of deficits of attention, arousal, consciousness, memory, orientation, perception, and speech or language. Akinetic mutism It may be of two types- - The patient lay inertly in bed mute and almost totally unresponsive, although he followed the movements of people around him with his eyes. H. Cairn described this state due to tumor of 3rdventricle, hence known as Cairn stupor. The syndrome is probably a result of interference with RAS, so that response to environment stimuli is defective. The term has also been used to describe subjects with bilateral frontal lobe lesions who lack all drive and impulse to action, despite intact motor and sensory tracts. - Coma vigil. Psedocoma / locked in syndrome / Deafferented state. It is a state in which patient appears to be asleep but can be aroused. The subject is conscious and aware but is unable to respond. The lesion is in ventral pons with preservation of dorsal tegmental area, the activating system is intact but interruption of corticobulbar and spinal pathways make it impossible for the subject to move or speak. [/INST] question: Mutism and akinesis in a person who appears awake and even alert, is best described as: | options: A: Stupor B: Coma C: Hysteria D: Delirium | answer: A </s> |
<s>[INST] context: Mr.Black was having a lot of trouble with her skin, so she went to her doctor about it. He could not find anything wrong with her, however. So he sent her to the local hospital for some tests. The hospital , of course, sent the results of the tests direct to Mrs. Black's doctor, and the next morning he telephoned her to give her a list of the things that he thought she could not eat, as any of them might the cause of her skin trouble.
Mrs. Black carefully wrote all the things down on a piece of paper, which she then left beside the telephone while she went out to a ladies' meeting.
When she got back home two hours later, she found her husband waiting for her .He had a big basket full of packages beside him, and when he saw her, he said , "Hello, dear. I have done all your shopping for you."
"Done all my shopping?"she asked in surprise. "But how did you know what I wanted?"
"Well, when I got home , I found your shopping list beside the telephone," answered her husband. "So I went down to the shops and bought everything you had written down."
Of course, Mrs. Black had to tell him that what he had bought were all the things the doctor did not allow her to eat. [/INST] question: Mrs Black went to her doctor _ . | options: A: for a diet of healthy foods B: for her skin disease C: to invite him to give a talk at a ladies' meeting D: to get the results of some tests | answer: B </s> |
<s>[INST] context: Dunphy’s sign :Any movement, including coughing, may cause pain.
Rovsing’s sign: Pain in the right lower quadrant during palpation of the left lower quadrant.
Iliopsoas sign: AKA “Obraztsova’s sign’ pain on extension of hip which relieves on flexing the hip into the “fetal position” (due to inflammation of the peritoneum overlying the iliopsoas muscles and inflammation of the psoas muscles themselves). Theis is typical of retrocecal appendix.
Obturator sign: Pain in flexion and internal rotation of the hip (due to irritation of obturator internus). This is typical of pelvic appendix.
Blumberg sign: Deep palpation of the viscera over the suspected inflamed appendix followed by sudden release of the pressure causes the severe pain on the site indicating positive Blumberg’s sign and peritonitis.
Volkovich –Kocher (Kosher)’s sign : The appearance of pain in the epigastric region or around the stomach at the beginning of disease with a subsequent shift to the right iliac region.
Sitkovsky (Rosenstein)’s sign : Increased pain in the right iliac region as patient lies on left side.
Bartomier – Michelson’s sign : Increased pain on palpation at the right iliac region as patient lies on leftside compared to when patient was on supine position.
Aure – Rozanova’s sign : Increase pain on palpation with finger in right Petit triangle. Typical in retrocecal position of the appendix. Boundaries of Petit triangle areiliac crest, External oblique muscle and Latissimus Dorsi muscle. [/INST] question: In case of appendicitis, if the pain is exacerbated on medial rotation of the thigh, the position of appendix is: | options: A: Pelvic B: Preileal C: Paracaecal D: Mid-inguinal | answer: A </s> |
<s>[INST] context: The nine-year-old Marc Yu is called Little Mozart. He is too short to reach the pedals of a piano. Marc, from California, USA, says, "The problem is that my legs aren't straight enough, so I have to get very close to the piano."
Marc's 34-year-old mother played Beethoven's CDs to him when she was pregnant . Marc started playing the piano at a birthday party when he was only two. While the other children were singing "twinkle, twinkle, little star ...", he walked over to the piano and started playing the song. It _ his mother, because that was the first time he'd been near a piano. Marc gave his first public performance, playing Beethoven, at six, the same age as Mozart. After that concert, Marc won a PS225,000 university scholarship.
At present he practices the piano eight hours a day. He also studies part-time at the famous Colbum Music School in Los Angeles, and flies once a month to China for lessons at Shanghai Music School. Marc says, "I like playing the piano because it makes me have a lot of different feelings --sadness, excitement, happiness and so on. I like playing difficult pieces, especially those that my teacher says I shouldn't." [/INST] question: The nine-year-old Marc Yu is from _ . | options: A: China B: France C: Canada D: the United States | answer: D </s> |
<s>[INST] context: Can dolphins talk? Maybe they can't talk with words, but they talk with sounds. They show their feelings with sounds.
Dolphins travel in a group. We call a group of fish a "school". They don't study, but they travel together.
Dolphins talk to the other dolphins in the school. They give information. They tell when they are happy or sad or afraid. They say "welcome"when a dolphin comes back to the school. They talk when they play.
They make a few sounds above water. They make many more sounds under water. People cannot hear these sounds because they are very, very high. Scientists make tapes of the sounds and study them.
Sometimes people catch a dolphin for a large aquarium . People can watch the dolphins in a show. Dolphins don't like to be away from their school in an aquarium. They are sad and lonely . Dolphins
There are many stories about dolphins. They help people. Sometimes they save somebody's life. Dolphin meat is good, but people don't like to kill them. They say that dolphins bring good luck. Many people believe this. [/INST] question: Dolphins show their feelings with _ . | options: A: pictures B: words C: water D: sounds | answer: D </s> |
<s>[INST] context: Sir,
Just over six months ago, I saw an advertisement in the Morning Mail for a set of the complete works of William Shakespeare. Your company, Cosmo books Ltd., offered this set (eight books of plays and two books of poetry) at what was claimed to be a 'remarkable' price: fifteen pounds and fifty pence, including postage and packing. I had wanted a set of Shakespeare's plays and poems for some time, and these books, in red imitation leather, looked particularly attractive; so I sent for them.
Two weeks later, the books arrived, together with a set of the complete works of Charles Dickens which I had not ordered. So I returned the Dickens books to you, with a cheque for fifteen pounds and fifty pence for the works of Shakespeare. Two more weeks passed. Then there arrived on my door step a second set of the works of Shakespeare, the same set of novels by Dickens and a six book set of the plays of Moliere, in French. Since I do not read French, these were of no use to me at all. However, I could not afford to post all these books back to you, so I wrote to you at the end of August of last year, instructing you to come and collect all the books that I did not want, and asking you not to send any other books until further notice.
You did not reply to that letter. Instead you sent me a bill for forty two pounds, and a set of the plays of Schiller, in German. Since then, a new set of books has arrived every two weeks, the works of Goethe, the poems of Milton, the plays of Strindberg; I hardly know what I have. The books are still all in their boxes, in the garage, and my car has to stand in the rain outside.
I have no room for any more books, and even if I read from now until the Last Judgment, I should not finish reading all the books that you have sent me.
Please send no more books, send no more bills, send no more angry letters demanding payment. Just send one large lorry and take all the books away, leaving me only with the one set of the complete works of Shakespeare for which I have paid.
Yours faithfully,
SIMON WALKER [/INST] question: Simon Walker wrote the letter to _ | options: A: urge for the final solution to the problem with the unwanted books B: complain about getting books he didn't want C: advise readers not to order books from Cosmo Books Ltd D: show his anger to Cosmo Books Ltd | answer: A </s> |
<s>[INST] context: Lensectomy In this operation most of the lens including anterior and posterior capsule along with anterior vitreous are removed with the help of a vitreous cutter. Childhood cataracts,both congenital/developmental and acquired, being soft are easily dealt with this procedure especially in very young children (less than 2 years of age) in which primary IOL implantation is not planned. Goniotomy Surgical procedure for congenital glaucoma In this procedure a Barkan&;s goniotomy knife is passed through the limbus on the temporal side. Under gonioscopic control the knife is passed across the anterior chamber to the nasal pa of the angle. An incision is made in the angle approximately midway between root of the iris and Schwalbe&;s ring through approximately 75deg. The knife is then withdrawn. Although the procedure may have to be repeated, the eventual success rate is about 85 percent. Phacoemulsification Phacoemulsification is a technique of extracapsular cataract extraction in which after the removal of anterior capsule (by capsulorhexis), the lens nucleus is emulsified and aspirated by the probe of a phacoemulsification machine. IOL Indication : Recent trend is to implant an IOL in each and every case being operated for cataract; unless it is contraindicated. However, operation for unilateral cataract should always be followed by an IOL implantation. [/INST] question: Which is not a cataract surgery- | options: A: Lensectomy B: Goniotomy C: Phacoemulsification D: IOL | answer: B </s> |
<s>[INST] context: When most of us hear the word chocolate, the verb that comes to mind is probably "eat", not "drink", and the most proper adjective would seem to be "sweet". But for about 90 percent of chocolate's long history, it was strictly a beverage , and sugar didn't have anything to do with it.
The Origin of Chocolate
Many modern historians have estimated that chocolate has been around for about 2000 years, but recent research suggests that it may be even older.
In the book The True History of Chocolate, authors Sophie and Michael Coe prove that the earliest linguistic evidence of chocolate consumption dates back three or even four thousand years.
Valuable and Fashionable Chocolate Beverage
It's hard to discover exactly when chocolate was born, but it's clear that it was cherished from the start. For several centuries in pre-modern Latin America, cacao beans were considered valuable enough to use as currency. 100 beans could purchase a good turkey hen, according to a 16th-century Aztec document.
Sweetened chocolate didn't appear until Europeans discovered the Americas and sampled the native cuisine. Chocolate didn't suit the foreigners' taste at first -- one described it in his writings as "a bitter drink for pigs" -- but once mixed with honey or cane sugar, it quickly became popular throughout Spain. By the 17th century, chocolate was a fashionable drink throughout Europe, believed to have nutritious, medicinal functions. But it remained largely a privilege of the rich until the invention of the steam engine made mass production possible in the late 1700s.
The Birth of Solid Chocolate
In 1828, a Dutch chemist found a way to make powdered chocolate. His product became known as "Dutch cocoa", and it soon led to the creation of solid chocolate. In 1847, Joseph Fry created the first modern chocolate bar. By 1868, a little company called Cadbury was marketing boxes of chocolate candies in England. Milk chocolate hit the market a few years later.
Prosperous Chocolate Industry
In America, chocolate was so valued during the Revolutionary War that it was used instead of wages. Even now, statistics show that the humble cacao bean is still a powerful economic force. Chocolate manufacturing is a more than 4-billion-dollar industry in the United States, and the average American eats at least half a pound of the stuff per month. [/INST] question: The earliest chocolate was most probably _ . | options: A: a dish B: a drink C: a bar D: a candy | answer: B </s> |
<s>[INST] context: Retinoblastoma: 1 Most common Intraocular tumor of childhood. 2. Malignant primary neoplasm of retina that arises from neuroectodermal cells of retina (pigment layer). 3. May be a congenital lesion that is present but not usually apparent at bih; average age of diagnosis is 13 months. 4. Principle symptom = unilateral blindness. 5. Primary sign = Leukocoria. 6. It is bilateral in about 30% cases. 7. It is histologically composed of round cells with 'Rosette' pattern 8. Other round cell tumors include neuroblastoma, Ewing's sarcoma, NHL, etc. When bilateral, follows AD with complete penetrance pattern. Chromosome 13 mutation (100% in B/L and 15% in U/L). Histopathology: Flexner Wintersteiner rosettes. It is a PNET. Morphologic forms 1. Endophytic 2. Exophytic 3. Diffuse form Type based on location 1. Unilateral (70%) 2. Bilateral (30%) 3. Trilateral (<1%) ? Bilateral RB plus pineal or suprasellar tumor 4. Tetra/Quadrilateral (< 0.1%) ? Bilateral RB plus pineal and suprasellar mass. CT Scan Calcification--Intraocular mass centered posteriorly in globe with moderate or intense CT with punctate or finely speckled calcification (<90%) with or without extraocular extension. MRI: best for seeing extraocular extension. Treatment: 1. Small sized tumor - (plaque or ext. beam) with/without vitreous seeding 2. Large RB - local extension: Enucleation ? External beam . 3. Unilateral tumor without invasion has excellent prognosis. Coats disease - Increased density in all or pa of vitreous in normal sized globe without calcification. Congenital cataract - Vitreous normal, lens is dense. [/INST] question: The mother of a one and a half year old child gives history of increasing proptosis of left eye for the past 1 month. Examination revels left eye white reflex. On computed tomography scan of the orbit there is left orbital mass with calcification mainly centred within the globe. The most likely diagnosis is? | options: A: Congenital cataract B: Retinoblastoma C: Endophthalmitis D: Coats disease | answer: B </s> |
<s>[INST] context: Sudden, painless monocular blindness is a sign of carotid disease. The symptom is also called amaurosis fugax . The patient may describe a shade dropping in front of the eye or describe vision like looking through ground glass. If a thrombus propagates up the carotid to the middle cerebral aery, then symptoms seen in middle cerebral aery occlusion or embolization (hemiparesis with sensory symptoms, aphasia depending on hemispheric dominance) will also occur. Midbasilar aery disease produces weakness and sensory loss with diplopia, loss of facial sensation or movement, and ataxia. Branches of the basilar aery supply the base of the pons and superior cerebellum. The symptoms described suggest disease in the posterior circulation, whichincludes paired veebral aeries, the basilar aery, and the paired posterior cerebral aeries. The basilar aery divides into two posterior cerebral aeries that provide branches to the cerebellum, medulla, pons, midbrain, thalamus, and temporal and occipital lobes. A midbasilar aery occlusion could cause ataxia of limbs by involving pontine nuclei; paralysis of the face, arm, and leg by involving coicospinal tracts; and impairment of facial sensation by involvement of fifth nerve nucleus. Occlusion of the entire middle cerebral aery results in contralateral hemiplegia, hemianesthesia, and homonymous hemianopsia. When the dominant hemisphere is involved, aphasia is present. When the nondominant hemisphere is involved, apraxia and neglect are produced. When only a penetrating branch of the middle cerebral aery is affected, the syndrome of pure motor hemiplegia is produced, as the infarct involves only the posterior limb of the internal capsule, involving only motor fibers to the face, arm, and leg (lacunar infarct). [/INST] question: For Sudden, painless monocular blindness select the site of the lesion of cerebrovascular disease, | options: A: Internal carotid aery B: Middle cerebral aery C: Midbasilar aery D: Penetrating branch, middle cerebral aery | answer: A </s> |
<s>[INST] context: STRONGYLOIDES The clinical disease may be classified as cutaneous, pulmonary and intestinal. The overwhelming severe disease seen in the immunocompromised is known as hyperinfection. Cutaneous There may be a dermatitis, with erythema and itching at the site of penetration of the filariform larvae, paicularly when large numbers of larvae enter the skin. In those sensitised by prior infection, there may be an allergic response. This may prevent circulation in the blood of the larvae, which may instead migrate in skin, leading to a form of creeping eruption or larva migrans. Pulmonary During escape of the larvae from the pulmonary capillaries into the alveoli, small haemorrhages occur, along with cellular infiltration into alveoli and bronchioles. Larvae may be found in the sputum. Intestinal The symptoms may resemble those of peptic ulcer or of malabsorption syndrome. Mucus diarrhoea is often present. In heavy infection, the mucosa may be honeycombed with the worm and there may be extensive sloughing, causing dysenteric stools. Hyperinfection In debilitated individuals, and paicularly in those with cellular immune defects, extensive internal reinfection takes place, leading to enormous numbers of adult worms in the intestines and lungs, and larvae in various tissues and organs. This is known as hyperinfection. Severe malnutrition, lepromatous leprosy, lymphoreticular malignancies, AIDS, immunosuppressive drugs and other situations in which cellmediated immunity is defective, predispose to this condition. Hyperinfection is an impoant hazard of steroid therapy and other instances of prolonged immunosuppression as in tansplant patients. Manifestations depend on the sites affected. Brain abscess, meningitis and peritonitis are major fatal complications. TEXTBOOK OF MEDICAL PARASITOLOGY;CKJ PANIKER;6TH EDITION;PAGE NO 173 [/INST] question: Infection with colitis is caused by - | options: A: Enterobius vermicularis B: Trichuris trichura C: Strongyliodes D: Clonorchis | answer: C </s> |
<s>[INST] context: You can improve your child's hearing memory considerably . Once his hearing memory has been greatly improved, he'll be able to use and remember what he listens to in class. The success of these suggestions depends upon your ability to use your child's natural desire to get involved in games he finds simple and fun.
A good way to begin is to read aloud a sentence from a book suitable for your child's reading age. Then ask your youngster to repeat the sentence back to you correctly. Next, reread the sentence, leaving out a particular word. See if your child can identify the word you left out. At the beginning use only simple sentences. Gradually, increase the length of the sentences. Make sure you don't rush things along too quickly, or your child may become discouraged and tired of the game.
Take your child shopping with you often. He's to remember a list of items you want to buy in the supermarket. First , ask him to remember only a few things. Then, as he shows increased ability to remember, make the list longer and longer. Praise him often and warmly when he shows increased ability to remember things. He'll become proud of his 'good' memory and will happily play the game.
Encourage your child to learn easy and short poems. As his ability to do this becomes stronger, encourage him to remember longer poems. Do the same with songs. [/INST] question: The suggestions will be successful if _ . | options: A: you find simple and funny games for your child B: you can stimulate your child's interest in the activity C: you force your child to get involved in more practice D: you improve your own hearing memory first | answer: B </s> |
<s>[INST] context: Stage Size of tumor T1 up to 2 cm T2 >2-5cm T3 >5cm T4a Extension to chest wall (chest wall is formed by Ribs, Intercostal muscles, Serratus Anterior) T4b Ulceration edema including Peau-D-Orange Satellite nodules These changes are confined to same breast. T4c T4a + T4b T4d Inflammatory breast cancer Not included in T4 Involvement of dermis alone Nipple retraction/ detion Involvement of Pectoralis major/ Pectoralis minor Lymph node (N) Staging N1 Metastasis to ipsilateral axillary lymph node level I and II Mobile N2a Metastasis to ipsilateral axillary LN I and II Fixed / matted lymph nodes N2b Clinically apparent internal / mammary nodes (detected on clinical examination /grossly visible pathologically/detected on radiological examination except lymphoscintigraphy) N3a Metastasis to ipsilateral infraclavicular LN N3b Metastasis to ipsilateral axillary + internal mammary LN N3c Metastasis to ipsilateral supraclavicular LN Metastasis M0 (r) No metastasis M1 (r) Distant Metastasis Stage I T1 Stage IIA TO-1 N1 T2 Stage IIB T2 N 1 T3 Stage IIIA To-2 N2 T3 N1-2 Stage IIIB T4 N0-2 Stage IIIc T any N3 Stage IV T any N any M1 [/INST] question: A 55 years old female presented with breast mass of size 3 cm with ulceration, edema and satellite nodules confined to the same breast with metastasis to ipsilateral axillary lymph node I & II and is mobile on examination. The staging of the breast cancer is: | options: A: Stage II B B: Stage III A C: Stage III B D: Stage IV | answer: C </s> |
<s>[INST] context: Based on the articulating surfaces of the prosthesis, THR may be of the following type:-
Metal on poly: One surface is metallic (femoral side) and the other is of polyethene (on the acetabular side).
Metal on metal: Both articulating surfaces are of metal.
Ceramic on ceramic: Both articulating surfaces are of ceramic.
Contraindications to Metal on Metal Bearing surfaces
(Metal on Metal Total Hip Replacement or Metal on Metal Hip Resurfacing)
Patients with Renal Insufficiency (Chronic Renal failure) (Kidney are chiefly responsible for eliminating metal ions from the blood)
Young females of childbearing age (Women who may potentially still have children) (Elevated levels of metal ions have harmful effects on the fetus)
Patients with metal hypersensitivity
Contraindications to (Metal on Metal) Hip Resurfacing (Not contraindications to Metal on metal articulation)
Loss of femoral head (severe bone loss: poor bone stock)
Large femoral neck cysts (poor bone stock: found at surgery)
The small or bone deficient acetabulum
Conditions that require caution: Associated with increased risk of failure
Tall thin patients
Female patients
Patients with femoral head cysts > 1 cm (on preoperative radiographs)
Patients with high body mass index > 35
Rheumatoid arthritis (Inflammatory arthritis) and Osteonecrosis (AVIV)
Rheumatoid arthritis (Inflammatory arthritis) and osteonecrosis of the hip/ perthe's disease were earlier considered contraindications/ semi- contraindications for Resurfacing. These have now shown to have successful results. [/INST] question: Metal on Metal articulation should be avoided in - | options: A: Osteonecrosis B: Young female C: Inflammatory arthritis D: Revision surgery | answer: B </s> |
<s>[INST] context: Marjorie Gestring
Marjorie Gestring was a springboard diver from the United States who won the gold medal in 3-meter springboard diving at the 1936 Summer Olympics in Berlin, Germany at the age of 13 years. With the cancellation of the Olympics in 1940 and 1944 because of World War II, Gestring did not get a chance to defend her title, and her comeback attempt for the 1948 Summer Olympics failed.
Bob Mathias
17-year-old American Bob Mathias won the decathlon only four months after taking up the sport. He is the youngest athlete in Olympic history to win a men's track and field event. By the time Mathias retired from decathlon competition in 1952, he had nine victories in nine competitions. He had won two gold medals separately in 1948 and 1952. In 1954 a film about his early life called The Bob Mathias Story was made, in which he and his wife played themselves.
Fu Mingxia
Fu Mingxia was born on August 16, 1978 in Wuhan, Hubei Province. At an early age, her father taught her to swim at a nearby river. She started exercising gymnastics at age 5, soon turning to diving. Fu Mingxia left home at age 9 to train in Beijing. In the 1992 Summer Olympics held in Barcelona, Fu Mingxia became China's youngest Olympic champion ever when she won the 10-meter platform gold at the age of 13.
Ian Thorpe
Ian Thorpe was born on 13 October, 1982. He is a former Australian freestyle swimmer. At the age of 14, he became the youngest male ever to represent Australia. Ian Thorpe, 17 years old, won the gold medal in the 400m freestyle by breaking his own world record in Sydney 2000. He has won five Olympic gold medals. [/INST] question: How many times has Marjorie Gestring taken part in the Olympic Games? | options: A: Two B: Three C: Four D: Five | answer: A </s> |
<s>[INST] context: Tony Burke, Australia's environment minister, says he won't decide until next year whether the koala should be protected as an endangered species. He was expected to make his decision by the end of October. But that decision has been put off. Burke said he needed more time to go over the latest information about the koala's population.
In September, an Australian Senate committee reported that there was no question the koala's population is on the decrease. "But they may not yet be eligible for listing as a threatened species," said Senator Doug Cameron. "To have such a significant Australian icon included on the threatened species list would be a national shame."
The koala is found only in the eucalyptus forests of Australia. And its population is reported to have fallen sharply for many reasons, including the cutting down of forests to make way for human beings' development, their own illness, climate change and killings by other animals such as wild dogs. And every year many koalas are hit by cars as they are trying to cross the busy roads.
Putting off the decision on protection for the koala "is really bad news," said Debbie Pointing, the president of the Koala Action Group. "We've worked tirelessly for many years to gather data on the populations," Pointing said. "That data should be enough to make a decision."
However, Burke pointed out that the Australian government had spent at least $6.3 million on koala conservation efforts since 1996. senators listed efforts that are already underway in Queensland - the construction of special koala bridges as well as fences along roads, to keep the animals out of harm's way.
Some people say that is not enough. "What we're doing at the moment is likely to drive this species to extinction," Queensland University zoologist Bill Ellis said.
"Koalas are an iconic Australian animal," Burke told Australians. "They hold a special place in the hearts of Australians."
But it is a fact that if more isn't done to protect the koala, they might soon hold a place only in Australians' memories. [/INST] question: Tony Burke put off announcing the koala as an endangered species because _ . | options: A: he needed more time to examine latest information B: he doubted whether koalas' number is decreasing C: he was thinking about ways to protect koalas D: he had more important issues to deal with | answer: A </s> |
<s>[INST] context: More and more people are trying to learn English than any other language in the world. English is the world language of politics and international business. It becomes the international language of science, medicine, sports, travel and so on.
In most schools in Asia, English is taught as the main foreign language. School children in China and Japan begin to learn English at an early age. English is the official language of more than seventy-five countries including Britain, Canada, the United States and Australia.
Many different languages are spoken in some countries. However, English is often used as an official language to help people communicate with each other. India is a good example. English is the common language in this country, but at least twenty-four languages are spoken there.
Do you know the history of English? Old English took many words from the French language. Most English words came from French, especially those words used for describing the law and the government, such as "damage"," prison "and " marriage". Then, English became what language experts called Middle English. The history of English continues as Middle English, and then it becomes Modern English, and it is spoken today.
,. [/INST] question: How many languages are spoken in India? | options: A: Less than 75 B: Less than 24 C: At least 24 D: At least 75 | answer: C </s> |
<s>[INST] context: In the southern part of America, when somebody has a birthday, often family or friends, or both, will arrange a party. The party could be elaborate and include a meal or may be simple with a birthday cake and drinks. One does not plan, nor give, one's own birthday as is the custom in some cultures. At a party there is usually a decorated cake, often with the words "Happy Birthday" and with the name of the person written on the top of the cake. Sometimes there is also one candle for each year of the person celebrating the birthday before the cake is cut. While blowing out the candles, the person makes a wish for something pleasant.
Usually those invited to a birthday party will bring a gift for the person honored. Gifts given by friends do not have to be expensive, but the family of the birthday person will spend whatever they can afford on a gift.
Christmas parties also are very popular in the South. Often this is the only time during the year that some people see acquaintances . These parties can be elaborate or simple, ranging from a buffet to a reception called "open house ". If you are invited to one of these, you don't need to take a Christmas gift, as it is not customary to take the hostess a gift every time you are invited to a party or a meal. However, if you wish to take a gift, it should only be something useful and inexpensive and should be given to the hostess at the door as you enter the party. Usually gifts of Christmas food treats are the most appreciated. [/INST] question: On one's birthday, before blowing out the candles, he or she will _ . | options: A: wear beautiful clothes B: make a wish C: invite friends D: eat birthday cake | answer: B </s> |
<s>[INST] context: Decussating fibres of lateral spinothalmic tract Dissociated sensory loss is a pattern of neurological damage which involves selective loss of pain and temperature with preservation of fine touch and proprioception. Pain and temperature are carried by lateral spinothalmic tracts, which cross the central pa of the cord sholy after entering the spinal cord and ascend in the contralateral side. Fine touch and proprioception are carried in dorsal column fibres which do not cross the cord until medulla. Since fibers conducting pain and temperature sensation cross the cord in the anterior commissure, a lesion in this location will characteristically abolish these modalities on one or both sides over several segments but will spare the tactile sensation (fine touch and proprioception). This is known as dissociated sensory loss and is a characteristic feature of the Central spinal cord syndrome (Syringomyelic Syndrome). The central spinal cord syndrome is best exemplified by syringomyclia, hydromyelia, hematomyelia, and intramedullary cord tumors. [/INST] question: Dissociated sensory loss in a case of tumor ofcentral spinal cord is due to lesion of: | options: A: Dorsal column fibres B: Anterior Spinothalmic tract C: Decussating fibres of lateral spinothalmic tract D: Cilio spinal centre of spinal cord | answer: C </s> |
<s>[INST] context: The Human Genome Project, a great $3 billion, 15-year task aimed at drawing the genetic map of humans, is now more than 90 percent completed. The scientific and medical communities are very excited about the chances genetic research provides for getting rid of diseases and prolonging human life. But those communities and policy makers are also careful about the scientific door they are opening as the project uncovers the mysteries of life.
For the last few years, the genetic advances in the fast developing field of biotechnology have provided material for all kinds of work, but the developments of modern science in unlocking the secrets of human genetic code have opened a world of possibilities for human health, as well as for the population imagination.
While European and Japanese researchers are making rapid progress in decoding human DNA, the leading organization for genetic research in the Untied States, which began in 1990, is "unlocking the code" of the human body to learn how to defeat fatal diseases. Already, the Human Genome Project has become widely known and praised for finding the genes connected with as yet terrible diseases, and making progress toward separating the genes that show a sign of breast cancer or AIDS.
Once these genes are found and studied, researchers can develop new ways to attack infections, and genetic diseases. Medical companies are very interested in mapping the human genome, as they expect to develop a lot of new drugs for these illnesses. [/INST] question: Why did the scientists work so hard at mapping the human genome? | options: A: Because the human genome can destroy many illnesses B: Because the human genome's completion can help to get rid of many diseases C: Because they wanted to be better known than others D: Because the Human Genome Project can provided a lot of chances of work | answer: B </s> |
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