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<s>[INST] context: On a BA flight from Johannesburg, a middle-aged South African lady found herself sitting next to a black man. She called the cabin crew attendant over to complain about her seating.
"What seems to be the problem, Madam?" Asked the attendant.
"Can't you see?" She said, "You've sat me next to a black. I can't possibly sit next to this dirty disgusting human. Find me another seat!"
"Please calm down, Madam," the attendant replied, "The flight is very full today, but I'll tell you what I'll do--I'll go and check to see if we have any seats available in club or first class."
A few minutes later, the attendant returned with the good news, which she delivered to the lady, who cannot help but look at the people around her with a smug and self-satisfied grin.
"Madam, unfortunately, as I guessed, economy is full. I've spoken to the cabin services director, and club is also full. However, we do have one seat in first class."
Before the lady had a chance to answer, the attendant continued.
"It's most extraordinary to make this kind of upgrade, however, and I have had to get special permission from the captain. But, according to this _ , the captain felt that it was unbelievable that someone should be forced to sit next to such an obnoxious person."
Having said that, the attendant turned to the black man sitting next to the lady, and said, "So if you'd like to get your things, sir, I have your seat ready for you."
At that moment, the surrounding passengers stood and gave a long-lasting ovation while the black man walked up to the front of the plane... [/INST] question: What made the white South African lady angry? | options: A: She had to find the attendant to complain B: She couldn't find another seat to sit down C: The passenger next to her is dirty D: She sat next to a black man | answer: D </s> |
<s>[INST] context: Olivia and Jack are the most popular names in Britain for babies born in 2008, according to a survey made by the website
. Jack has been top for 14 years since it took over from Thomas.
Grace -- made famous by the Hollywood star Grace Kelly -- slipped back into third place behind Ruby, the name of singer Charlotte Church's daughter.
Summer climbed 28 places from 44th to 16th. Ava -- the name of singer Myleene Klass's daughter -- also leapt 15 places to 19th.
The troubles of the singer Amy Winehouse perhaps had an effect on the popularity of the name. It dropped three places to 23rd. Rebecca is also on the wane
, ranking 48th. So is Courtney, which ranked 88th.
Theo, obviously inspired by England's teenage football hero Theo Walcott, is among the biggest climbers in the boy's list, rising from 70th to 58th.
An employee of
said, "Baby names have witnessed the biggest changes over the last decade as parents are increasingly influenced by celebrities. The Bounty baby name poll also shows parents are continuing to be creative and inspirational about the names they choose for their children. Some parents want a name that's totally unique, and names such as Zebedee, Selim and Zenon are now emerging and growing in popularity. Others are simply breaking with convention and becoming bolder in their choice of names."
"While politicians' names may be growing in popularity in America, British politicians don't influence our choice of names in the UK. Traditional royal names continue to be supreme
in the boys' top 100," The employee said. [/INST] question: Which of the following girl names ranks the second? | options: A: Grace B: Ruby C: Kelly D: Charlotte | answer: B </s> |
<s>[INST] context: Walt Disney was born in 1901. He created the Mickey Mouse in 1927 . It made him very famous . He died in 1966, but his work and his dreams did not die. Now people all over the world enjoy his Mickey Mouse and other cartoons.
Walt Disney was a man who did not _ easily. One summer, he wanted a job in a post
office, but they told him that he was too young. He went home, drew some lines on his face. And put on his father's suit and hat. Then he went back to the same office and told them he was 18. He got the job finally.
Later in his life, Mr. Disney had a dream . He wanted to build a new kind of amusement park. It would be clean and beautiful. The children could play happily there and the adults could live in nice hotels . It would be fun for people of all ages . It was called Disneyland. Engineers told him it was an impossible dream. His family and friends thought he was mad. But Mr. Disney did not give up his idea. In1955, Disneyland opened to the public and became the most successful amusement park in the USA. Walt Disney's dream came true. [/INST] question: When did Walt Disney creative his Mickey Mouse ? | options: A: in 1927 B: in 1955 C: in 1901 D: in 1966 | answer: A </s> |
<s>[INST] context: In the UK. Saturday evenings have always been a popular time for families to watch television together. One of the most popular programme _ is the talent show, partly because people of all ages are interested in it.
Early shows, like Opportunity Knocks (1965-1978), required people to vote for their favorite acts and performers, although in those days voting was done by postcard instead of by telephone, text, or over the Internet. Today, the success of television talent shows has reached a new level. Here are Ihe UK's top three TV talent shows:
The X Factor In this wonderful singing competition, performers have to face a celebrity judge panel before the public vote. Many excellent singers became popular because of it. The show is now made all over the world, from China to Colombia.
Strictly Come Dancing--The programme is so fantastic that it attracts many celebrities. They team up with professional dancers and come to the dance floor to win the title of Strictly Come Dancing Champion.
Britain's Got Talent -- In this modern-day version of Opportunity Knocks, the public can go and choose from many kinds of acts, from dancing dogs to ice skating. The prize is to perform for the Queen in the Royal Variety of Performance. [/INST] question: When did the show Opportunity Knocks begin? | options: A: In 1965 B: In 1978 C: In 2015 D: K is not mentioned | answer: A </s> |
<s>[INST] context: There are a lot of differences in life in the US that you can only learn by living here. However, we will try to introduce you to some of the more important cultural differences.
Personal Space
When two people are talking to each other, they tend to stand a distance apart. Each person has an invisible boundary around their body into which other people may not come.
Interestingly,the average personal distance varies from culture to culture. Americans tend to require more personal space than in other cultures. So if you try to get too close to an American during your conversation, he or she will feel that you are "in their face" and will try to back away.
Try to avoid physical contact while you are speaking, since this may also lead to _ .
Tipping
Restaurants do not include a service charge in the bill, so you should tip the waiter 15% of the total bill. If service is slow or particular bad, some Americans will tip only 10%. If service is particularly good, it is appropriate to tip 20%. If service is so bad that you will never eat in the restaurant again, leave two cents. It tells the waiter that you haven't forgotten to leave a tip. Tipping is only appropriate in restaurants which offer table service. You do not tip the cashier in a fast food restaurant.
Gestures
To wave goodbye or hello to someone, raise your hand and wave it from side to side, not front to back. Wave the whole hand, not just the fingers. Waving the hand front to back or the fingers up and down means "no", "stop", or "go away'. Holding your hand up with the palm facing forward but no movement means "stop".
If you want to point at an object, extend the index finger and use it to point at the object. It is not polite to point at people.
Although showing your fist with the thumb up or your open hand with the tips of the thumb and index finger together forming an "O" means "OK", these are stereotypes . Americans understand these gestures, but they are mainly used by actors in movies, not in real life. [/INST] question: If an American to whom you are speaking backs away a little, you'd better _ . | options: A: not try to close the gap B: stop talking with him or her C: back away too D: ask him or her what happened | answer: A </s> |
<s>[INST] context: Synthesis of collagena. The polypeptide chains of preprocollagen are synthesized on the rough endoplasmic reticulum, and the signal (pre) sequence is cleaved.b. Proline and lysine residues are hydroxylated by a reaction that requires O2 and vitamin C.c. Galactose and glucose are added to hydroxylysine residues.d. The triple helix forms, and procollagen is secreted from the cell and cleaved to form collagen.e. Cross-links are produced. The side chains of lysine and hydroxylysine residues are oxidized to form aldehydes, which can undergo aldol condensation or form Schiff bases with the amino groups of lysine residues.A defect in the synthesis or processing of collagen will lead to a variety of diseases, of which Ehlers-Danlos syndrome is one (osteogenesis imperfecta is another). Parkinson disease is caused by low levels of dopamine in the nervous system. In the initial stages of Parkinson disease, giving dihydroxyphenylalanine (DOPA) can reduce the severity of the symptoms because DOPA can be decarboxylated to form dopamine. DOPA can easily enter the brain, whereas dopamine cannot. Tay-Sachs disease results from an inability to degrade GM2, a ganglioside (it is also a sphingolipid). The enzyme missing is b-hexosaminidase. McArdle disease is caused by a defective muscle glycogen phosphorylase, such that the muscle cannot generate glucose from glycogen, leading to exercise intolerance. Maple syrup urine disease is caused by the lack of branched-chain a-keto acid dehydrogenase activity, a necessary step in the metabolism of the branched-chain amino acids (leucine, isoleucine, and valine). [/INST] question: Ehlers-Danlos syndrome can be caused by a problem with the metabolism of which particular compound. | options: A: Glycogen B: Collagen C: Dopamine D: Valine | answer: B </s> |
<s>[INST] context: Not many years ago,a wealthy and rather strange old man named Johnson lived alone in a village in the south of England. He had made a lot of money in trading with foreign countries. When he was seventy-five, he gave PS 12,000 to the village school to buy land and equipment for a children's playground.
As a result of his kindness, many people came to visit him. Among them was a newspaperman. During their talk,Johnson remarked that he was seventy-five and expected to live to be a hundred. The newspaperman asked him how he managed to be healthy at seventy--five. Johnson had a sense of humor. He liked whisky and drank some each day. "I have an injection in my neck each evening." he told the newspaperman,thinking of his evening glass of whisky.
The newspaperman did not understand what Johnson meant. In his newspaper he reported that Johnson was seventy-five and had a daily injection in his neck. Within a week Johnson received thousands of letters from all over Britain,asking him for the secret of his daily injection. [/INST] question: Johnson became a rich man through _ . | options: A: making whisky B: doing business C: buying and selling land D: having an injection each night | answer: B </s> |
<s>[INST] context: In a tuberculin skin test, T cell proliferation is increased by secretion of interleukins. An extract of tuberculin (an antigen of lipoprotein composition obtained from the tubercle bacillus) is injected into the skin of a person who has had tuberculosis or has been immunized against tuberculosis. Merriory helper T cells react to the tuberculin and secrete Il-2, which up regulates Il-2 receptors. Il-2 binding to Il-2 receptors on the same cell is an example of autocrine regulation in which a cell secretes a ligand for a receptor on its own surface. The result of this up regulation and ligand receptor binding is an increase in T cell proliferation. T cell derived cytokines such as tumor necrosis factor-alpha and beta (TN Fα and β) induce leukocyte recruitment. Production of gamma-(γ)-interferon by helper T cells attracts and activates macrophages (monocytes comprise most of the cellular infiltrate). γ -Interferon also converts other cells (such asendothelial cells) to antigen-presenting cells by induction of class II MHC expression, which further augments the response. The result of the activity of helper T cells is a dramatic increase in the number of lymphocytes and macrophages at the test site, which produces swelling. IL-I is synthesized by antigen-presenting cells and macro phages with helper T cells as the targets. [/INST] question: In a positive tuberculin skin test, helper T cells assist in which of the following ways? | options: A: Autocrine-mediated inhibition of proliferation of helper T cells B: The down regulation of IL-2 receptors on helper T cells C: Secretion of interleukins that promote T cell proliferation D: Secretion of IL-I | answer: C </s> |
<s>[INST] context: Qi Baishi (1863~1957) is one of the best-known contemporary Chinese artists. His life shows he achieved success by combining talent with hard work.
He was born in a peasant family. At 11 he was sent to learn carpentry . Through his work he got to know some local scholars. One of them, Hu Shenyuan, offered to teach his painting and poetry. During this period he earned his living by painting portraits and selling his works. Gradually he developed a reputation as an artist as well as a carpenter. In those years he devoted himself to poetry, calligraphy , and seal-carving. Although he admitted he was a versatile artist, his own criteria of his successes placed poetry first, seal-carving second, calligraphy third, and painting last.
From 1902 to 1916, Qi toured the country five times, and he left his footmarks in many cities, such as Beijing and Hongkong. The trips broadened his vision and changed his style. In 1917 he settled down in Beijing, where he met many artists and scholars, and made friends with Chen Shizeng. Chen advised him not to _ early masters and to form his own style.
Through long years of practice, Qi Baishi evolved a distinctive personal style. The subjects of his painting were wide and various, and the flowers, birds, fish, prawns , and insects he painted are most admired by his public. To improve his technique of painting prawns, he raised some at home and frequently observed their movements. He wrote in his diary about how he had changed his method of painting prawns: "At first my prawns owned a reasonable similarity, then they became even more realistic, and finally light and dark color1s became properly contrasted. These are the three changes." Qi Baishi was able to portray the same object in either the xieyior thegongbistyle. When he painted a dragonfly in a detailed manner, he even drew the veins in its wings. When he adopted a , free style, he used only a few dry, expressive strokes to form it. What is fascinating about his work is that in some pictures both methods are used. [/INST] question: In his early life, what was Qi Baishi famous for? | options: A: Painting B: Poetry C: Calligraphy D: Seal-carving | answer: B </s> |
<s>[INST] context: I am Alice. I like We chat. It is fast, convenient and fashionable. And you can use it for free. It can be used in my mobile phone. It has hold-to-talk voice messaging function. I am a fan of Leehom Wang. Through We chat, Leehom Wang often says something to me. It's amazing.
I am David. I love Micro blog. I update my Micro blog when I am free. We can share instant messages with each other. I often look through Yao Chen's Micro blog. She has many followers. I make many friends with them. I often write something on my Micro blog, for example, "I'm in blue today. I didn't pass the exam." Then many friends comfort me. I share my birthday party, my new phone, my new coat, etc. with my friends. It is fun.
I'm Lily. I don't like We chat or Micro blog. I don't believe them. There are so many crimes on We chat. Many people are cheated because they believe in other people they meet on We chat easily. It is not a real world. As to Micro blog, I don't think it is a good way to make friends. And you should write something no more than 140 words. I like keeping diaries. I don't want my secrets known by others. I am a low-key girl. [/INST] question: Who loves Micro blog? | options: A: Alice B: David C: Lily D: Leehom Wang | answer: B </s> |
<s>[INST] context: A 51-year-old lawyer has moved back in with his mother-after giving up his Los Angeles home to a family of strangers for a year.
Tony Tolbert looked for a family in need after his father set a glowing example when he was growing up by always welcoming people to stay in their spare room. "You don't have to be Bill Gates or Warren Buffet or Oprah," Tolbert told CBS. "We can do it wherever we are, with whatever we have, and for me, I have a home that I can make available. " His mother, Marie Tolbert, added, " He is go giving, and he's always been that way. "
Tolbert went to Alexandria House, a shelter for homeless women and children, and came across Felicia Dukes, who lived in a single bedroom with three of her children. Her family had been separated as the shelter was just for children and her eldest son was unable to join them. Tolbert told the staff he wanted to bring the. family back together, and offered his home.
The family has now moved into the three-bedroom, two-bathroom home - with Duke's oldest son. It is worth nearly $400,000, according to online estimates. "My heart just fills up with appreciation, " Dukes said, as she wiped away her tears.
The heartwarming story comes after the report that l0-year-old Gracie McNulty, from England, served Christmas dinners t0 50 homeless people, achieving her fathers last Christmas wish.
Her father Craig, 38, was a regular charity volunteer who had served breakfast to the homeless on Boxing Day. But as a roofer, he suffered serious head injuries when he fell while working. And 'he died soon after the accident in August.
"It's been the best Christmas ever, " Cracie said. "I was just at school feeling sad and so I decided I wanted to do something to make him proud and this felt like the perfect thing. " [/INST] question: Tony Tolbert offered help to others because he was inspired by _ ' | options: A: his mother B: his teacher C: his father D: his son | answer: C </s> |
<s>[INST] context: Each child has his individual pattern of social, as well as physical, development. Some of it depends on his home life and his relationships with the people who love him. Children in large families learn how to get along with others through normal brother- sister play and tussles . An only child, on the other hand , may have to learn his lessons in social living through hard experiences on the playground or in the classroom. Twins who always have one another to lean on may be slow in responding to others because they do not need anyone else.
A child who is constantly scolded and made to feel he does everything wrong may have a difficult time developing socially. He may be so afraid of displeasing the adults around him that he keeps to himself (where he can't get into trouble)or he may take the opposite route and go out of his way to create trouble. Like the deserted child, he too may return to infantile pleasures, developing habits that will satisfy him, but create barriers toward social contact. [/INST] question: Which of the following may have effect on children's paten of social development? | options: A: Age B: Education C: Home life D: Gender | answer: C </s> |
<s>[INST] context: Dr Asim Syed, 32, has performed more than 100 operations at London's Hammersmith Hospital in the country's busiest transplant unit, but never imagined that he would one day become a donor himself.
He stepped forward when was told his 64-year-old mother might be dead within months unless she got a new kidney . The worried surgeon brought her to London to be cared for at his hospital. However, it was not all plain sailing. Tests showed Dr Syed was the wrong blood group, so the only way was to go through a special blood-washing process. He consulted colleagues about that, but they didn't agree, because the risk of rejection is still too high. Dr Syed and his mother were then advised to consider a new way of donating and receiving, called an organ-paired. That is, Dr Syed donated his kidney to an unknown person and another donor in the chain was a successful match for his mother. The chain of three transplants took place at the same time on July 31 with Dr Syed's kidney going to a recipient in the Midlands and Mrs. Syed receiving her kidney from a person in the south of England.
Just hours after donating his own kidney, Dr Syed found himself recovering in bed next to his mother. Mrs Syed said, "When I came round from my operation Asim was in the next bed and the first thing he said was, 'Mum now all your worries are over.' Tears fell down."
Now mother and son are recovering well with Dr Syed already back at work. Mrs. Syed is staying with him for several months while the hospital monitors her progress.
He said, "I did what anyone would do when they see a relative suffering disease. Although I wasn't able to help mum directly, by agreeing to be part of a chain, I was also very happy." [/INST] question: Why isn't it a plain sailing? | options: A: No one can treat his mother well B: Dr Syed was the wrong blood group C: They didn't have money to be in hospital D: Mrs. Syed was unwilling to receive the operation | answer: B </s> |
<s>[INST] context: Radial nerve injury
- High radial nerve palsy- Injury above the spiral groove.
o Paralysis of all muscles supplied by radial nerve.
o Clinical features
Wrist drop, finger drop, thumb drop
Extension affected of- elbow, wrist, thumb and fingers
Sensation affected of- posterior surface of arm and forearm and lower lateral half of forearm.
- Low radial nerve palsy- Injury below the spiral groove.
o Type I- Injury between spiral groove and elbow.
Elbow extensors are spared- Triceps and Anconeus.
Wrist, thumb and finger extensors paralysed- wrist drop, thumb drop, finger drop.
Loss of sensation on dorsal side of first web space.
o Type II- Injury below the elbow joint.
Elbow and wrist extensors spared
Thumb and finger extensors paralysed.(extensor digitorum, extensor digiti minimi, extensor indicis, extensor pollicis longus, extensor pollicis brevis)- Thumb drop and finger drop.
Loss of sensation on dorsal side of first web space.
In radial nerve head surgery, the most common nerve to get injured is posterior interosseous nerve. There is thumb and finger drop. Extension of wrist is spared. [/INST] question: A. 30-year-old male underwent excision of the right radial head. Following surgery, the patient developed inability to extend the fingers and thumb of the right hand. He did not have any sensory deficit. Which one of the following is the
most likely cause? | options: A: Injury to Posterior interosseus nerve B: Iatrogenic injury to common extensor origin C: Injury to anterior interosseus nerve D: High radial nerve palsy | answer: A </s> |
<s>[INST] context: Long March exhibit
The Shanghai History Museum is putting on an exhibition to mark the 60th anniversary of the Long March. On show are more than 220 photos and 40 items that explain with pictures how the communist Red Army drew back from its besieged bases in Jiangxi Province and fought its way to northern Shaanxi Province in the mid-1930s. Explanations are all in Chinese. The show will end on November 20.
Time: 10:00 am-4:00 pm
Address: 1286 Hongqiao Road
Admission: 8 yuan for Chinese /15 yuan for foreigners
Thai elephants
Eight elephants from Thailand are entertaining visitors at Changfeng Park by riding bikes, playing basketball, balancing on a beam, dancing and blowing a mouthorgan. People are encouraged to have a tug-of-war with the animals or lie on the ground and have the elephants walk over them. The elephants give three shows a day at 9:30 am, 3:30 pm and 8:00 pm and there is an additional show at l:30 pm at weekends. The show will end on November 15.
Address: 189 Daduhe Road
Admission: 30-40 yuan
Dancing dolphins
Dolphins jumping from the water to touch a ball, swaying their bodies to music, kissing people and doing math by tapping their tails have made the dolphinarium in Peace Park an attraction for children. Seals and sea lions also perform.
Hours: 10:30 am, 4:00 pm, and 7:30 pm
Admission: 20 yuan for adults and 10 yuan for children. [/INST] question: If you go to visit the Long March exhibit with an Australian, how much will you pay altogether for the admission ? | options: A: 16 yuan B: 23 yuan C: 30 yuan D: 20 yuan | answer: B </s> |
<s>[INST] context: A thousand years ago, Hong Kong was covered by a thick forest. As more and more people came to live in Hong Kong, these trees were cut down and burnt. Now there is no forest left, though there are still some small areas covered with trees. We call these woods.
Elephants, tigers and many other animals were living in the thick forest. When people came to live in Hong Kong, the animals began to die out. Early farmers grew rice and kept pigs and chickens in the valleys. They cut down the trees and burnt them. They needed fire to keep themselves warm in winter, to cook their food and to keep away the dangerous animals. Elephants quickly disappeared because there was not enough food for them. Many other animals soon died in the same way.
You might think that there are no longer any animals in Hong Kong except in 2005. But there are still about 36 different animals living there. One of the most interesting of Hong Kong's animals is the barking deer. These are beautiful little animals with a rich brown coat and a white patch under the tail. They look like deer but they are much smaller. They are less than two feet high. They make a noise rather like a dog barking. In Hong Kong the barking deer has only a real enemy---- men. People hunt these little animals though it is illegal, There are now not many barking deer left. So it is important for people to protect wild animals. [/INST] question: There was _ in Hong Kong a thousand years ago. | options: A: a mountain B: the woods C: a thick forest D: a hill | answer: C </s> |
<s>[INST] context: Blockage of the arachnoid granulations would most likely cause a communicating, or nonobstructive, hydrocephalus.
Hydrocephalus is an increase in cerebrospinal fluid (CSF) volume with distention of the ventricles. It may be caused by (1) overproduction of CSF, which is uncommon (e.g., in neoplasms of the choroid plexus); (2) decreased absorption of CSF from the arachnoid villi that is caused by an organizing meningitis with fibrosis blocking the arachnoid granulations, dural sinus thrombosis, or organization of blood clot in a subarachnoid hemorrhage; or (3) obstruction of CSF flow within the ventricles with distention of the ventricles proximal to the block, in conditions such as a
colloid cyst of the third ventricle, stenosis of the duct of Sylvius, tumor (e.g., ependymoma, medulloblastoma) in the fourth ventricle, or the blockage of flow out of the foramina of Luschka and Magendie by pus (tuberculous meningitis) or blood. Blockage of CSF flow within the ventricles produces an obstructive, or noncommunicating hydrocephalus. Blockage of the resorption of CSF out of the subarachnoid space produces a communicating hydrocephalus, because there is still an open communication between the ventricles and the subarachnoid space. In any of these situations, the ventricles dilate under the increased pressure and are easily identified by computerized tomography scans or magnetic resonance imaging. [/INST] question: Which of the following most likely causes a com¬municating (nonobstructive) hydrocephalus? | options: A: Tuberculous meningitis B: Stenosis of the duct of Sylvius C: Ependymoma of the fourth ventricle D: Blockage of the arachnoid granulations | answer: D </s> |
<s>[INST] context: There are many different kinds of music in the world . Let's read some kinds of them .
Classical Music
Classical music is a form of music needing high musical skills . If you wish to learn this kind of music , you have to go through proper training .
Metal Music
Metal music came out after the Second World War . The melody of the song is heavily influenced by the structure for it . It is also know as " information music ". While in metal music , songwriting is based on(......)a form .
Hip-hop Music
This music always includes the use of instruments such as the guitar , violin , piano , bass , drums and so on . In this type of music , the bass is the main instrument . It was first played by a group of travelling singers and poets of West Africa .
Opera Music
It first appeared in Italy in the 1600s . It has a great mixture of theatrical art and musical invention and is used to playing in the theaters .
Jazz Music
This type of music has strong and complex melodies . The main musical instruments are comet , trumpet or violin , that help carry the melody .
Besides these , there are many others such as the blues , new age music , Celtic music , religious music and chamber music . [/INST] question: _ Music needs high musical skills . | options: A: Classical B: Metal C: Hip-hop D: Opera | answer: A </s> |
<s>[INST] context: prefix = st1 /Britainis facing a sharp rise in its rat population as growing numbers of people leave fast food scraps in the street , an environment group warned . Keep Britain Tidy said the rodents were stopping their traditional hunts underground and were roaming the streets ,tempted by discarded burgers ,pizzas and crisps. "The rat population is on the rise and soon it'll be as common to see a rodent on our street as it is to see a dog or a cat," said group Director ,Sue Nelson. The practice of dumping fast food litter and scraps on the street rather than in the trash-with young men the worst offenders-was behind the rise. According to the National Rodent Survey in 2005, Britain's rat population has grown by nearly one quarter since 2000 and is now estimated at 60 million , two million more than the human population. On average a rat can give birth every 24--28 days and just a single pair of rats can produce a colony of 2,000 a year. Around 200 people a year get Weil's Disease----an infection which can lead to liver or kidney failure and eventually death and which is arrived in rat's waste. To highlight the issue , Keep Britain Tidy launched a cinema ad entitled "How close do you want them to get?" The advertisement gave a shocking image of a young woman sleeping in a bed of rots, echoing the nightmare scene from James Herbert's classic horror tale The Rats, in which mutant rodents begin to prey on humans. [/INST] question: Where did the rodents use to search for food? | options: A: In the Street B: Under the ground C: From the trash cans D: In burger shops | answer: B </s> |
<s>[INST] context: Cardiogenic shock (CS) is characterized by systemic hypoperfusion due to severe depression of the cardiac index and sustained systolic aerial hypotension (<90 mmHg) despite an elevated filling pressure . It is associated with in-hospital moality rates >50%. . Circulatory failure based on cardiac dysfunction may be caused by primary myocardial failure, most commonly secondary to acute myocardial infarction(MI) , and less frequently by cardiomyopathy or myocarditis , cardiac tamponade, or critical valvular hea disease Systolic and diastolic myocardial dysfunction results in a reduction in cardiac output and often pulmonary congestion. Systemic and coronary hypoperfusion occur, resulting in progressive ischemia. Although a number of compensatory mechanisms are activated in an attempt to suppo the circulation, these compensatory mechanisms may become maladaptive and produce a worsening of hemodynamics. *Release of inflammatory cytokines after myocardial infarction may lead to inducible nitric oxide expression, excess nitric oxide, and inappropriate vasodilation. This causes fuher reduction in systemic and coronary perfusion. A vicious spiral of progressive myocardial dysfunction occurs that ultimately results in death if it is not interrupted. LVEDP, left ventricular end-diastolic pressure ref:harrison&;s principles of internal medicine,ed 18,pg no 2232 [/INST] question: . In cardiac shock | options: A: SBP<90mmof Hg B: DBP<80mmof Hg C: Urine output < 20 ml\/hr D: Cardiac index < 3.5 | answer: A </s> |
<s>[INST] context: Book now to see Keira Knightley and Elisabeth Moss star in The Children's Hour at the Comedy Theatre in London.
Dates: 22 January 2011 to 31 January 2011
Times: 22 Jan 2011 6:30 PM; 24--29 Jan 2011 7:30 PM; 29 Jan 2011 2:30 PM; 31 Jan 2011 7:30 PM.
Place: Comedy Theatre
The Children's Hour
The Children's Hour by Lillian Hellman is a striking play about the power of a lie. Karen Wright (Keira Knightley) and Martha Dobie (Elisabeth Moss) run a girls' boarding school in the 1930s New England. When an angry student starts a rumour that the two headmistresses are having a lesbian affair, it gradually destroys the women's careers, relationships and lives. The Children's Hour is an upsetting story of cheat, shame and courage.
Banned in London and several cities across America, The Children's Hour received its world opening on Broadway in 1934. Generations on, its exploration of a culture of fear remains remarkably relevant.
Keira Knightley and Elisabeth Moss Star
Keira Knightley, nominee for Best Actress 2010 Evening Standard Awards for The Misanthrope, returns to the London stage. Knightley starred in Love Actually, The Pirates of the Caribbean Trilogy, Pride and Prejudice.
Elisabeth Moss, best-known for playing Peggy Olson in Mad Men, made her Broadway stage debut in David Mamet's Speed the Plow in 2008. The Children's Hour will be her West End debut.
Book The Children's Hour Tickets
Book theatre tickets to see The Children's Hour at London's Comedy Theatre today. With two big stars in the leading roles, The Children's Hour tickets are sure to sell fast. Book yours online now with Visit London's secure ticket booking partner on this wetsite. Just click the green book button to buy your The Children's Hour tickets. [/INST] question: If you visit London in January, at which time can you see the play? | options: A: 21 Jan 2011 6:30 PM B: 23 Jan 2011 2:30 PM C: 26 Jan 2011 2:30 PM D: 31 Jan 2011 7:30 PM | answer: D </s> |
<s>[INST] context: Welcome to Adventureland!
Everyone loves Adventureland! The parks and exhibitions were built for you to explore
, enjoy, and admire their wonders. Every visit will be an unforgettable experience. You
will go away enriched, longing to come back. What are you going to do this time?
The Travel Pavilion
Explore places you have never been to before, and experience different ways of life. Visit the Amazon jungle village, the Turkish market, the Tai floating market, the Berber
mountain house and others. Talk to the people there who will tell you about their lives, and
things they make. You can try making a carpet, making nets, fishing...
The Future Tower
This exhibition shows how progress will touch our lives. It allows us to look into the
future and explore the cities of the next century and the way we'll be living then. Spend some
time in our space station and climb into our simulator for the Journey to Mars!
The Nature Park
This is not really one park but several. In the Safari Park you can drive among African
animals in one of our Range Cruisers: see lions, giraffes, elephants in the wild. Move on to theOcean Park to watch the dolphins and whales. And then there is still the Aviary to see...
The Pyramid
This is the center of Adventureland. Run out of film, need some postcards and stamps?
For all these things and many more, visit our underground shopping center. Come here for
information and ideas too. [/INST] question: If you are interested in knowing about what people's life will be, you may visit _ . | options: A: the Travel Pavilion B: the Safari Park C: the Future Tower D: the Pyramid | answer: C </s> |
<s>[INST] context: The world is not only hungry but also thirsty for water. This may seem strange to you, since nearly 70% of the earth's surface is covered with water. But about 97% of that is sea water or salt water. Man can only drink and use the other 3% of fresh water from rivers, lakes, underground and so on. And we can not even use all of that because some of it has been made dirty.
Earth Day is April 22. But on all other days, we must also remember how important water is. The water that we use is the most important natural resource on the earth. Today we face serious water problems. One of them is water pollution. All kinds of things from cars, factories, farms and homes make our rivers, lakes and oceans dirty. Polluted water is very bad for people to drink. And dirty water is bad for fish, too.
How do cars and factories make our water dirty? First they pollute the air. Then when it rains, the rain water makes our drinking water dirty. Dirty rain, called acid rain is also bad for plants, animals and buildings. Scientists say that in 30 years, more than half of the people in the world won't have enough clean water. We have to learn how to stop wasting water. One of the first steps is to develop ways of reusing it. Today in most large cities, water is used only once and then sent out into a sewer system . From there it returns to the sea or goes underground.
But even though every large city reused its water, we would still not have enough. So we should make use of sea water by removing the salt in it. If we can take these steps, fresh water won't be used up. [/INST] question: The world is thirsty for water because _ . | options: A: we don't have enough fresh water B: a lot of water goes into sewer systems C: only 70% of the earth's surface is water D: sea water is widely used rather than fresh water | answer: A </s> |
<s>[INST] context: Little Mike's grandma died weeks ago. He missed her very much. One afternoon Mike went to the city park where his grandma used to go. There he saw an old lady. She looked very kind. She was sitting there, watching pigeons . Little Mike went up and sat next to her. He took out his food and drinks and gave some to her. She smiled at him. Her smile was so sweet that Mike wanted to see it again. She seemed to understand him, so once again she smiled. Mike was very glad.
They sat there all the afternoon, eating and talking. As it got dark, Mike got up to leave. Before he left, he hugged the old lady and she gave him her sweetest smile.
When Mike got home, his mother was surprised by the look of joy on his face. "I met a granny in the park. Her smile was like the kind of smile I had seen on Grandma's face."
The old lady also returned to her home happily. She told her son that she had food and drinks with a little boy. "He was as lovely as Brittany," she said. Her son was surprised, because he had never seen her so happy since Brittany, her grandson, died weeks ago.
. [/INST] question: Little Mike went to the park and _ . | options: A: played with pigeons B: fed pigeons C: met an old lady D: saw a friend of his grandma's | answer: C </s> |
<s>[INST] context: The World Bank is warning that the West Africa Ebola outbreak could seriously harm the economies of Guinea, Liberia and Sierra Leone unless action is taken quickly. World Bank President Jim Yong Kim spoke to reporters recently to discuss the effects of the Ebola spread.
"Our findings show that if the virus continues to spread, the economic cost to these countries could grow eight times by 2015. This would be a big _ to their already weak economies," said Kim.
Mr. Kim says, "saving lives and preventing new spread" is most important. The bank has given $117-million for an "immediate help." The World Bank President says the SARS outbreak between 2002 and 2004 showed how a disease could damage economies. 800 people died from SARS and the economic losses were up to $40-billion.
Mr. Kim says SARS and the H1N1 outbreak of 2009 taught that fear and avoidance resulted in about 90-percent of the economic losses. That means the disease is causing two levels of economic damage.
"There are two kinds of contagion . One is connected with the virus itself and the second is connected with the spread of fear about the virus," said Kim.
The World Bank thinks the losses to the economies of Liberia, Sierra Leone and Guinea will be big .Mr. Kim says losses could be about $97-million at the moment.
Mr. Kim says fast action is necessary. He says getting the disease under control is still far away. That is because there are not enough health care workers in the affected areas. The World Bank President says the most important measure is to act quickly in order to limit economic losses. [/INST] question: If quick action is not taken to stop the spread of Ebola, the economic losses could reach about _ by 2015. | options: A: $800-million B: $97-million C: $117-million D: $40-billion | answer: A </s> |
<s>[INST] context: If you go to visit London, you'll see a lot of buses and cars on the road. You'll also see many bikes because more people travel by bike. Why? There are many reasons. First, it is very cheap to buy a bike, and it is quick, too. You often need to wait for a bus for half an hour. When the bus comes, there are so many other buses and cars on the roads, so the bus moves very slowly.
I travel to work by bus for about four years. I often arrive at work late and feel tired. Then one day, a friend of mine says, "I go to work by bike. Why don't we travel together?" "Because my bike is old, and there are so many buses and cars on the roads. I'll feel frightened." I answer. "Don't be afraid, if you follow me and we ride slowly, you'll be fine." he says.
Later, I buy a new bike. We go slowly, but we arrive at work quickly. I spend 40 minutes going by bus, but only half an hour by bike! Now I love riding a bike. And I feel healthy. Many people think my idea is good and maybe you'll see more bikes on the road in the future. [/INST] question: I travel to work by bus for _ . | options: A: one year B: half a year C: about four years D: two years | answer: C </s> |
<s>[INST] context: Rob Kalin learned the secret to success while he was still in his baby bed. At age one, the Boston-bom teacher's son dragged around a stuffed rabbit that had been lovingly sewn by one of his mother's students. True, one of the ears was sewn on backward, but that just added to its magic. "It was always special to me," Kalin remembers of his first handmade craft .
Kalin's appreciation for the simple and the simply eccentric inspired him to create etsy. com, an online craft fair, probably the largest market for handmade goods in the world. Last year, 350,000 woodworkers and other craftsmen sold their one-of-a-kind crafts on the four-year-old site.
They sell everything from hand-knit sleeves for Macbooks ($32) to myrtle-wood electric guitars ($3,200). And in an age of chain stores, it seems there's still a big market. More than three million consumers in 150 countries purchased about $87.5 million worth of crafts on Etsy last year.
Emily Worden, founder of Elemental Threads, a custom handbag and jewelry company, signed up with Etsy when she started her company two years ago. She pays Etsy a 20-cent standard fee for each item she lists on the site, plus a 3.5 percent commission on everything sold. Etsy allows her to track the number of times customers click on a particular item to view it. "We can see that our necklaces are a popularly viewed item and which color1s and sizes get the most views," she says. "That is a guide to evolving our product lines."
Today, Etsy's staff has ballooned to 70 employees, and the company reportedly earns more than $12 million a year.
Kalin's father was a carpenter and taught him early on how to use his hands. Indeed, in high school, he put his skills to work -- developing the photos of his classmates and handcrafting a graduate ID to attend design classes. Eventually, he was admitted to New York University, studying classics and working as a carpenter.
Kalin has also started sewing some of his own clothes. "I have to make something physical at least once a month," says Kalin, "or I go crazy." [/INST] question: What do we know about the crafts sold on etsy.com? | options: A: They are cheap B: They are unique C: They are made by famous craftsmen D: They are designed for young artists | answer: B </s> |
<s>[INST] context: "Beating is a sign of affection, cursing is a sign of love."
Many may not expect to hear the words of the old Chinese saying in these modern Times--
with parents wealthier and better educated than they have ever been--but experts say they still
ring true.
Today,it seems,Chinese parents are more likely to send their children to precollege military
academies in the United States in the hope that some tough love will pave the way to success.
"Good education doesn't mean letting your children enjoy privileges, especially our boys."
said Song Wenming,an entrepreneur in Jinhua,East China's Zhejiang province. "They should be raised in tough conditions to know what to fight for in the future."
In August,Song sent his 17yearold son to Valley Forge Military Academy (VFMA) in
Pennsylvania. _ .
Statistics show that an increasing number of Chinese students have been registering with such academies.
A few years ago, there were no Chinese students at Valley Forge. Today,there are 28."All of the Chinese students at Valley Forge came from wealthy families;some of them were spoiled." said Jennifer Myers, director of marketing and communications at the school.
Song's only son, Song Siyu, had a rocky start during his first six weeks at the school. The
teenager said he went to the school voluntarily but did not expect it to be as difficult.
Now, three months later, he has perfected the art of taking a bath in 35 seconds, finishing a
meal without looking at his food, and making his bed with precision. He can even take criticism,no matter how unreasonable.
"The training is hard but I know it is good for selfdevelopment of individuals." said SongSiyu.
"The endless training and scolding are just ways to build up our character;they are not personal."
But his enthusiasm is not universal. Ten of the 13 Chinese students who joined the academy
this year have transferred to other schools.
But for those who stick to it, there is a reward for all the hard work. [/INST] question: How many Chinese students are there at Valley Forge before this year? | options: A: 10 B: 13 C: 15 D: 25 | answer: D </s> |
<s>[INST] context: The summer holidays are upon us again. Here is our guide to summer holiday fun in Peterborough!
Peterborough Museum
The Age of the Dinosaurs' is the museum's main attraction this summer. Get up close to prehistoric creatures via some great hands---on exhibits! Watch out for monsters lurking around every ember! The museum is open from 10:00 am to 5:00 pm Monday to Saturday, and from 12:00 pm to 4:00 pm on Sundays in August.
Call 01733 864663 for details.
Saxon Youth Club
School holiday fun: Young people aged 13-19 will be able to produce their own music, compete in spots activities, or try their hand at cooking at Saxon Youth Club, Saxon Community Center, Norman Road, Peterborough every Monday and Wednesday from 3:00 pm. PLUS an aero ball tournament will take place on Thursday, 12thAugust between 3:30 pm and 6:30 pm.
Houghton Mill
Alice through the Looking Class---a new production of the family favorite on Monday, 30thAugust. Bring rugs or chairs to sit on and a picnic if you wish to eat during the play. Gates open 5:30 performance 6:30 pm---8:30 pm. Tea room will be open until end of the interval. Adult PS10. Child PS 7. Family PS 20.
Farmland Museum and Denny Abbey
Farmland Games: From Wellie Wanging to Pretend Ploughing matches, come and join the Farmland Team. Collect your sporting stickers and create a colorful rosette that is fit for a winner! No need to book, just turn up between 12:00 pm and 4:00 pm on Thursday, 19thAugust. Suitbale for children aged four and above, each child should be accompanied by an adult and all activities are included in the normal admission price. Tickets Cost PS 7 per child.
For further information, call 01223 810080. [/INST] question: If you are interested in cooking, you can go to _ . | options: A: Peterborough Museum B: Houghton Mill C: Saxon Youth Club D: Farmland Museum | answer: C </s> |
<s>[INST] context: According lo a new survey . Students' safety has become a big problem .Nearly 50% of students say they are worried about robbery on the way to and from school.Now in main big cities.in China some schools have taught all unusual lesson: self-protection. Students like this lesson because there are no exams or boring classes. And they can learn how to save lives and know how to stop danger before it really happens.
Chen Haoyu, a teacher at Beijing No 25 Middle School .give young students advice on how to deal with danger
If you are robbed
Keep calm.lf youcan not cry for help or run away.Give the robber your money.Try to remember what the robber looks like and tell the police later. If you are in a traffic accident.
It a car hitsyou. You should remember the car number.If it is a bicycle. Try to call your parents before you let the rider go. This is because you don't know how seriously you are hurt
If it is raining hard and there is lighting.
Don't stay in high places and stayaway from trees.
When there is a fire.Get away as fast as yon can.Put wet things on your body and try to find an exit.Do not lake the lift.
If someone is drowning
If you can't swim. don't get into the water. Cry out for help.
Remember that danger is never as far away as you think.Take care of yourself at alI times! [/INST] question: What will you do if a bicycle hurts you? | options: A: I will remember the bicycle number B: I won't let the rider go until I rail my parents C: will let the rider go before I call my parents D: I will letthe rider go because I know how seriously I am hurt | answer: B </s> |
<s>[INST] context: Word travelled quickly in the small fishing village of Port Washington, Wisconsin. So when McCarty wanted to build a playground for kids with special needs. 2,800 people - a third of the town - rolled up their sleeves and helped her.
"A lot of learning comes through play," said McCarty, 52, a special education teacher for 28 years. But her students were too often left out. She'd seen the traditional playgrounds stop wheelchairs dead in their tracks.
On September 16, 2008, the first day of the project, they came. Two women heard about the project on the way to work and took the day off to help. A couple in their 80s took part in the job. Children came and gave a helpful hand. Many were volunteers. They all worked very hard.
Today, Possibility Playground is one of the most popular _ in Ozaukee County. All children can play shoulder to shoulder. There is special equipment in different parts. Here, you see all the kids on the same playground having fun.
"People used to ask. 'Why do you want to build a playground just for children with disabilities?' " McCarty said. "They didn't get it. It's only when you build a playground for children with disabilities that you build one for all children." [/INST] question: What's McCarty? | options: A: A special doctor B: A special education teacher C: A special singer D: A special designer | answer: B </s> |
<s>[INST] context: Beck Cognitive therapy is a psychotherapy developed by American pyschiatrist Aaron T. Beck. Cognitive therapy is one of the therapeutic approaches within the larger group of cognitive behavioural therapies. Cognitive therapy seeks to help the client overcome difficulties by identifying and changing dysfunctional thinking, behaviour and emotional responses. This involves helping clients develop skills for modifying beliefs, identifying distoed thinkings, relative to others in different ways and changing behaviours. Treatment is based on collaboration between client and therapist and on testing beliefs. Therapy may consist of testing the assumptions which one makes and identifying how some of one's usually unquestioned thoughts are distoed, unrealistic and unhelpful. Once, those thoughts have been challenged, ones feelings about the subject matter of those thoughts are more easily subject to change. Beck initially focussed on depression and developed a list of errors in thought that he proposed could maintain depression, including arbitrary inference, selective abstraction, over generalization and magnification (of negatives) and minimization (of positives). According to Beck's theorey of the etiology of depression, depressed people acquire a negative view of the world in childhood and adolescence. Children and adolescent who suffer from depression acquire this negative view earlier. Depressed people acquire such view through a loss of a parent, rejection by peers, (criticism from teachers or parents, the depressive attitude and other negative events). When the person with such view encounters a situation that resembles the original conditions of the learned view in some way, even remotely, the negative views of the persons are activated. A simple example may illustrate the principle of how cognitive therapy works Having made a mistake at work, a person may believe "I am useless and can't do anything right at work". Strongly believing this then tends to worsen his mood. The problem may be worsened fuher if the individual reacts by avoiding activities and then behaviourally confirming the negative belief to himself. As a result, any adaptive response and fuher constructive consequences become unlikely, which reinforces the original belief of being useless. In therapy, the latter example could be identified as a self fulfilling prophecy or "problem cycle" and the effos of the therapist and client would be directed at working together to change it. [/INST] question: Cognitive model of depression is given by ? | options: A: Ellis B: Beck C: Godfrey D: Meicheinbanon | answer: B </s> |
<s>[INST] context: Parents need to be good role models to help their children make sensible financial decisions, according to Adam Hancock and his team, from East Caronlina University in the US. Their work highlights that parents who argue about finances contribute to increasing credit card debt among their children during their students years. Their work is published online in Springer's Journal of Family and Economic Issues.
Credit card debt among college students has been a growing concern for researchers and policymakers over the last decade. In addition, there is growing concern among educators that more students are dropping out of school, not because of academic failure, but because of financial reasons, and credit card especially.
Hancock and colleagues' study is the first to examine how parental interactions, and financial knowledge and attitudes may have a cumulative effect on the number of credit cards students own and their level of credit card debt.
The researchers analyzed data for 420 undergraduate students from seven different American universities, who took part in the College Student Financial Literacy Survey. According to the online survey, nearly two-thirds of students had a credit card, and nearly a third had more than one. Those students who reported that their parents argued about finances were more likely to have more than two cards than the students whose parents who did not argue about finances.
In terms of debt, those students who had two or more credit cards were nearly three times more likely to report having credit card debt over $500.
The researchers conclude, "It is clear that the influence of parents cannot be neglected. Researchers, educators and policymakers should work in finding effective ways to increase the positive financial behaviors for college students. We need to help students learn financial skills and establish healthy financial attitudes at earlier ages to prevent poor financial habits from taking root. " [/INST] question: In Adam Hancock's research, student's credit card debt is related to their _ . | options: A: knowledge B: concerns C: school D: parents | answer: D </s> |
<s>[INST] context: Papa's jaw dropped when Mama told him that Sister had cheated on her final exams--not to succeed but to fail. "It's unbelievable!" he said. "Sister has always been so proud of her good grades!"
"Yes, she has," said Mama. "But it's not unbelievable. It just shows how badly she wanted off the swimming team."
"Wanted off the swimming team?" said Papa. "She never said anything about that to me."
"Of course she didn't," said Mama. "She was afraid you'd _ . You already had her getting a swimming scholarship to college and winning gold medals at the Olympics. Can you imagine how much pressure she must have felt? For her, being on the team couldn't have been much fun."
"Oh, my gosh!" Papa said, clapping a hand to his forehead. "I've been so stupid! I just thought she'd want to be a champion swimmer because she's so good at it."
"It's like anything else, dear," said Mama. "No matter how good at it you are, if it stops being fun, you won't want to do it anymore."
Papa put his head in his hands.
"She must be really mad at me," he mumbled. "Maybe I should say sorry to her."
Sister's footsteps could be heard on the stairs. She came into the kitchen and looked hopefully up at her parents.
"Honey," said Mama with a smile, "your papa and I have decided that there's no reason for you to be on the swimming team if you don't want to."
Sister's face lit up like a Christmas tree. "Yippee!" she cried.
"And," added Papa, "there's no need for any more drills. I'm sure you'll bring your grades back up all by yourself."
Sister ran to Papa and jumped into his arms. She gave him a big hug. "I'm going to go play cards with Lizzy!" she said. "See you later!"
From the kitchen window, Mama and Papa watched their daughter run down the sunny road toward Lizzy's house.
"It's good to see her happy again," said Mama.
"It sure is," Papa agreed. "As for the swimming team, there's always next year."
"If?" Mama prompted him.
"Oh, right," said Papa. "If she wants to."
Mama smiled. "At least you're learning, dear," she said. She kissed him.
"Well, you know what they say," Papa said. "Better late than never." [/INST] question: Mama insisted that the child should do _ . | options: A: what she was willing to B: what she felt easy to C: what she was able to D: what she felt right to | answer: A </s> |
<s>[INST] context: (b) Source: (Hay et al, p 397. Kliegman et al, p 2262. McMillan et al, pp 839-840. Rudolph et al, p 1262.) Pityriasis rosea is a benign condition that usually presents with a herald patch, a single round or oval lesion appearing anywhere on the body. Usually about 5 to 10 days after the appearance of the herald patch, a more diffuse rash involving the upper extremities and trunk appears. These lesions are oval or round, slightly raised, and pink to brown in color. The lesion is covered in a fine scale with some central clearing possible. The rash can appear in a Christmas tree pattern on the back, identified by the aligning of the long axis of the lesions with the cutaneous cleavage lines. The rash lasts 2 to 12 weeks and can be pruritic. This rash is commonly mistaken for tinea corporis, and the consideration of secondary syphilis is important.Treatment is usually unnecessary but can consist of topical emollients and oral antihistamines, as needed. More uncommonly, topical steroids can be helpful if the itching is severe. Lichen planus is rare in children. It is intensely pruritic, and additional lesions can be induced with scratching. The lesion is commonly found on the flexor surfaces of the wrists, forearms, inner thighs, and occasionally on the oral mucosa. Seborrheic dermatitis can begin anytime during life; it frequently presents as cradle cap in the newborn period. This rash is commonly greasy, scaly, and erythematous and, in smaller children, involves the face, neck, axilla, and diaper area. In older children, the rash can be localized to the scalp and intertriginous areas. Pruritus can be marked. Contact dermatitis is characterized by redness, weeping, and oozing of the affected skin. The pattern of distribution can be helpful in identification of the offending agent. The rash can be pruritic; removal of the causative agent and use of topical emollients or steroids is curative. Psoriasis consists of red papules that coalesce to form plaques with sharp edges. A thick, silvery scale develops on the surface and leaves a drop of blood upon its removal (Auspitz sign). Additional lesions develop upon scratching older lesions. Commonly affected sites include scalp, knees, elbows, umbilicus, and genitalia. [/INST] question: The adolescent shown presents with a 14-day history of multiple oval lesions over his back. The rash began with a single lesion over the lower abdomen (A); the other lesions developed over the next days (B). These lesions are slightly pruritic. Which of the following is the most likely diagnosis? | options: A: Contact dermatitis B: Pityriasis rosea C: Seborrheic dermatitis D: Lichen planus | answer: B </s> |
<s>[INST] context: The secretion of estrogen by the developing follicle can best be explained using the "two cell" hypothesis. Theca cells are stimulated by LH (theca cells express LH receptors prior to formation of the corpus luteum, choice D) to secrete the androgens androstenedione and testosterone. The androgens then diffuse into the granulosa cells, where they are aromatized to estrogens. Hence, theca cells express side-chain cleavage enzyme (first step in steroidogenesis) prior to the formation of the corpus luteum . FSH stimulates aromatase activity in the granulosa cells (receptors for FSH and aromatase enzyme are present prior to the formation of the corpus luteum, choices A and B). The granulosa cells apparently have the ability to produce steroids (progesterone), but lack 17a-hydroxylase activity and cannot synthesize estrogen themselves. Only as the follicle approaches ovulation do LH receptors begin to be expressed by the granulosa cells. Estrogen and FSH probably are responsible for the change. After ovulation, the scar of the follicle undergoes luteinization. The theca cells decrease 17a-hydroxylase activity and secrete more progesterone. The granulosa cells decrease aromatase activity and also secrete more progesterone. [/INST] question: In the transition from a Graafian follicle to a functional corpus luteum, which of the following cellular events occurs? | options: A: Granulosa cells begin to express aromatase B: Granulosa cells begin to express FSH receptors C: Granulosa cells begin to express LH receptors D: Theca cells begin to express LH receptors | answer: C </s> |
<s>[INST] context: Nearly 300 miles long, up to 18 miles across and 4000 vertical feet down, the 8th new wonder: the splendid Grand Canyon .
Viewing its glory, President Theodore Roosevelt called the Grand Canyon "a natural wonder, ly unparalleled throughout the rest of the world". He urged Americans to preserve what he described as the "wonderful greatness, the nobleness, the great loneliness and the beauty of the canyon". More than a hundred years later, it's still easy to see why almost 5 million annual visitors call the Grand Canyon a wonder.
The canyon stretches as far as the eye can see. Some 5 or 6 million years ago, the Colorado River rushed through this land, carving out the massive canyon we see today, exposing even older layers of rock previously buried. Geologists say some are 2,000 million years old. Native Americans were the first people to make these rocky walls as their homes about 12,000 years ago.
Today the Hualapi and Havasupai Indians live deep in the canyon, balancing age-old traditions with modernity. There are no roads to this village; mules carry the mail here. But at the same time, the tribes are designing a skywalk that promises an excellent view over the canyon early next year. The bald eagle, wild and endangered American icon is another longtime resident of the Grand Canyon. [/INST] question: President _ sang high praise for the Grand Canyon. | options: A: Bush B: Clinton C: Roosevelt D: Washington | answer: C </s> |
<s>[INST] context: After too long on the Net, even a phone call can be a shock. My boyfriend's Liverpudlian accent suddenly becomes too difficult to understand after his clear words on screen; a secretary's tone seems more rejecting than I'd imagined it would be. Time itself becomes fluid--hours become minutes, and alternately seconds stretch into days. Weekends, once a highlight of my week, are now just two ordinary days.
For the last three years, since I stopped working as a producer for Charlie Rose, I have done much of my work as a tele-commuter. I submit articles and edit them by E-mail and communicate with colleagues on Internet mailing lists. My boyfriend lives in England; so much of our relationship is computer-mediated.
If I desired, I could stay inside for weeks without wanting anything. I can order food, and manage my money, love and work. In fact, at times I have spent as long as three weeks alone at home, going out only to get mail and buy newspapers and groceries. I watched most of the blizzard of '96 on TV.
But after a while, life itself begins to feel unreal. I start to feel as though I've merged with my machines, taking data in, spitting them back out, just another node on the Net. Others on line report the same symptoms. We start to strongly dislike the outside forms of socializing. It's like attending an A. A. meeting in a bar with everyone holding a half-sipped drink. We have become the Net opponents' worst nightmare.
What first seemed like a luxury, crawling from bed to computer, not worrying about hair, and clothes and face, has become an avoidance ,a lack of discipline. And once you start replacing real human contact with cyber interaction, _ can be quite difficult.
At times, I turn on the television and just leave it to chatter in the background, something that I'd never done previously. The voices of the programs relax me, but then I'm jarred by the commercials. I find myself sucked in by soap operas, or needing to keep up with the latest news and the weather. "Dateline", "Frontline" , "Nightline," CNN, every possible angle of every story over and over and over, even when they are of no possible use to me. Work moves from foreground to background. [/INST] question: Compared to the clear words of her boyfriend on screen, his accent becomes _ . | options: A: unreal B: unbearable C: misleading D: not understandable | answer: D </s> |
<s>[INST] context: September 21, 2050----At a press conference today it was announced that the first tourist heading for Mars will be the 38-year-old US businessman Patrick Clifford. He will leave the earth in the launching window of June 2052 and set his foot on the surface of Mars in November, together with the other 6 astronauts assigned for the mission to further explore the planet.
Patrick has now two years of training ahead of him to get ready for the trip. Not only will he spend five months in getting to Mars, but another 600 days there before he can go back home. Patrick was of course very excited, " This has been my dream since I was four, and seeing the first man on Mars 20 years ago made me realize that it was possible."
To be able to pay the $ 1. 3 billion for his ticket for the trip Patrick sold his majority stake in the company his father had built. "I know that my father would have been proud of me if he had still been alive today, he knew what this means to me", says Patrick. _ but it is said that he was paid twice as much for his part of the company.
So, how is he going to spend his 600 days on the red planet? "Well, since I don't have a job when I get back after selling the company, I have plenty of time to come up with a new business idea", he says and laughs. If he brings a shovel he can start building the first hotel there, but maybe he shouldn't expect too many guests until someone can offer a cheaper ticket. [/INST] question: How long will Patrick Clifford be away before he comes back? | options: A: About five months B: About two years C: About 600 days D: About 750 days | answer: D </s> |
<s>[INST] context: A. Dear Mrs. Web
Dear Mrs. Web provides free personal advice and opinions for you. She receives and answers worldwide e-mail questions . She will offer you some new suggestions on your problems, like study project, problems in making friends... Dear Mrs. Web welcomes all questions and suggestions. You can receive the reply usually in 48 hours. Her e-mail address is mrsweb @ advice com
B. Help Line Volunteers
Every year thousands of old people are in need of our help. The Help Line provides a heartwarming. helpful, kind support and free information service for the English-speaking aged people.
We are in need of volunteers who are :good listeners, warm-hearted and patient; excellent English speaker; can work 10 hour every week.
Please call us at 0241-85902 or e-mail us at [email protected].
C. Save the Earth Club
Earth club is for any student in Green School. Earth Club's goal is to help keep the school, neighborhood and city cleaner by encouraging recycling, highway clean up, and river, lake and school campus clean up. We hope to improve the environment and encourage others to do the same. We also need to discuss some real solutions to save the earth. Earth Club meets 2-4times a month. Come and join us!
D. The King Sweeper
"My great, great grandfather invented the carpet sweeper 125years ago. This King Sweeper is by far the best. I invite you to try it in your home. You'll find it used daily in hospitals, restaurants, offices and homes throughout the world. This is just the thing to keep your carpet soft , clean and fresh. Only for $59.99!
We are so sure that you will be satisfied with the results of using our product.
E. Trendy Sunglasses
They can protect your eyes when driving, gardening or reading in the sun. It can make your life easier and happier, and make you look smarter! $20.99 each or 2 for$39.99! [/INST] question: People who get help from Dear Mrs. Web or Help Line Volunteers _ . | options: A: have to pay for it B: have to help others C: must be quite poor D: needn't pay for it | answer: D </s> |
<s>[INST] context: During all this time I never stopped thinking about escape. When I traveled across to the other side of the island, I could see the other islands, and I said to myself, "Perhaps I can get there with a boat. Perhaps I can get back to England one day."
So I decided to make myself a boat. I cut down a big tree, and then began to make a long hole in it. It was hard work, but about six months later, I had a very fine canoe . Next, I had to get it down to the sea. How silly I was! Why didn't I think before I began work? Of course, the canoe was too heavy. I couldn't move it! I pulled and pushed and tried everything, but it didn't move. I was very unhappy for a long time after that.
That happened in my fourth year on the island. In my sixth year I did make myself a smaller canoe, but I did not try to escape in it. The boat was too small for a long journey, and I did not want to die at sea. The island was my home now, not my prison, and I was just happy to be alive. A year or two later, I made myself a second canoe on the other side of the island. I also built myself a second house there, and so I had two homes.
My life was still busy from morning to night. There were always things to do or to make. I learnt to make new clothes for myself from the skins of dead animals. They looked very strange, it is true, but they kept me dry in the rain.
I kept food and tools at both my houses, and also wild goats. There were many goats on the island, and I made fields with high fences to keep them in. They learnt to take food from me, and soon I had goats' milk to drink every day. I also worked hard in my corn fields. And so many years went by. [/INST] question: The purpose of making a canoe on the island was to _ . | options: A: escape in it B: get to the other side of the island C: use it for food D: go around the island | answer: A </s> |
<s>[INST] context: A 16 years old female presents with recurrent abdominal pain but biochemical assays and ultrasound abdomen is normal. After waking up from sleep, she suddenly complains of loss of vision of bilateral eyes. Ophthalmologist finds nothing on examination.
This condition is most probably due to Malingering.
Malingering is fabricating or exaggerating the symptoms of mental or physical disorders for a variety of 'secondary gain' motives, which may include financial compensation
(often tied to fraud); avoiding school, work or military service; obtaining drugs; getting lighter criminal sentences, or simply to attract attention or sympathy.
Malingering Fabricating or exaggerating the symptoms of mental or physical disorders for a variety of ‘secondary gain' motives, which may include financial compensation (often tied to fraud);
avoiding school, work or military service; obtaining drugs: getting lighter criminal sentences: or simply to attract attention or sympathy.
Malingering can lead to abuse of the medical system, with unnecessary tests being performed and time being wasted by the clinician as opposed to those with legitimate health problems.
Malingering can exist in a variety of intensities, from pure (in which all symptoms are falsified) to partial, in which symptoms are exaggerated.
Treatment: Treatment lies in the clinician being able to detect the disorder.
Cues for the clinician include If the patient has legal problems Potential for financial reward,
antisocial personality disorder If the patient’s story is in congruent with known facts or other informant accounts If the patient will not cooperate while being evaluated Psychological evaluation is
also recommended as a way to diagnose malingering, in particular, the Minnesota Multiphasic Personality Inventory (MMPI-2) as this measure has validity scales of value for this purpose.
The MMPI-2 provides objective, scientifically based information about whether an individual has responded honestly to the test,
or whether he or she has exaggerated or minimized psychological problems (possibly to obtain an external incentive, such as money damages in a personal injury lawsuit). [/INST] question: A 16 years old female presents with recurrent abdominal pain hut biochemical assays and ultrasound abdomen is normal. After
waking up from sleep, she suddenly complains of loss of vision of bilateral eyes. Ophthalmologist finds nothing on
examination. This condition is most probably due to | options: A: Bilateral optic neuritis B: Posterior cerebellar artery infarct C: Occipital hemorrhage D: Malingering | answer: D </s> |
<s>[INST] context: My name is Valentine. I lived in Rome during the third century. That was long, long ago! At that time, Rome was ruled by an emperor named Claudius. I didn't like Emperor Claudius, and I wasn't the only one! A lot of people shared my feelings.
Claudius wanted to have a big army. He expected men to volunteer to join. Many men just did not want to fight in wars. They did not want to leave their wives and families. As you might have guessed, not many men signed up. This made Claudius furious. So what happened? He had a crazy idea. He thought that if men were not married, they would not mind joining the army. So Claudius decided not to allow any more marriages. Young people thought his new law was cruel. I thought it was preposterous! I certainly wasn't going to support that law!
Did I mention that I was a priest ? One of my favourite activities was to marry couples. Even after Emperor Claudius passed his law, I kept on performing marriage ceremonies -- secretly, of course. It was really quite exciting. Imagine a small candlelit room with only the bride and groom and myself. We would whisper the words of the ceremony, listening all the while for the steps of soldiers. One night, we did hear footsteps. It was scary! Thank goodness the couple I was marrying escaped in time. I was caught. I was thrown in jail and told that my punishment was death.
I tried to stay cheerful. And do you know what? Wonderful things happened. Many young people came to the jail to visit me. They threw flowers and notes up to my window. They wanted me to know that they, too, believed in love.
On the day I was to die, February 14, 269 A.D. I left my friend a little note thanking a girl, who helped me keep my spirits up, for her friendship and loyalty. I signed it, "Love from your Valentine." [/INST] question: Valentine was put in prison because _ . | options: A: he secretly got married B: he attracted the emperor C: he didn't serve in the army D: he helped young people get married secretly | answer: D </s> |
<s>[INST] context: In earliest times, men considered lightning to be one of the great mysteries of nature. Some ancient people believed that lightning and thunder were the weapons of the gods.
In reality, lightning is a flow of electricity formed high above the earth. A single flash of lightning 1.6 kilometers long has enough electricity to light one million light bulbs .
The American scientist and statesman, Benjamin Franklin, was the first to show the connection between electricity and lightning in 1752. In the same year he also built the first lightning rod . This device protects buildings from being damaged by lightning.
Modern science has discovered that one stroke of lightning has a voltage of more than 15 million volts . A flash of lightning between a cloud and the earth may be as long as 13 kilometers, and travel at a speed of 30 million meters per second.
Scientists judge that there are about 2,000 million flashes of lightning per year. Lightning hits the Empire State Building in New York City 30 to 48 times a year. In the United States alone it kills an average of one person every day.
The safest place to be in case of an electrical storm is in a closed car. Outside, one should go to low ground and not get under tress. Also, one should stay out of water and away from metal fences. Inside a house, people should avoid open doorways and windows and not touch wires or metal things. [/INST] question: People once thought lightning came from _ . | options: A: the gods B: the earth C: the sky D: nature | answer: A </s> |
<s>[INST] context: Dear Lucy,
In your last letter, your asked me how to love to your parents. Here is my advice.
*Make a picture for them. Whether with pencils or paints, it will be a treasure to them forever.
*Write a letter to them. Take your time to put your thoughts in _ .
*keep your room clean! Though it's a kind of the chore, it shows mom and dad that care.
*Cook them a dinner! It can be some rice , some cheese or some hot dogs; it can give them a break.
*tell them that you love them very often. Your love can make them feel warm and proud.
*Never tell a lie to them. Probably the biggest way to show them you love them is, never to lie. This shows them that you not only love them, but also believe in and respect them.
*Create time to be with them. Watch a film with your mom once in a while, or go to a sports match with your dad once in a while just to show them how much you care and want to close with them.
*If you do something wrong, apologize and explain it! They will know you are sorry. You could do something for them to show you want to make it up to them. Just saying sorry can really show how much you love them.
Yours ,
Agony Aunt [/INST] question: _ can give your parents a break. | options: A: Studying for a test B: Drawing a picture C: Cooking a dinner D: Telling your love to your parents | answer: C </s> |
<s>[INST] context: Refer Robbins page no 728 9/e Chronic recurrent oral aphthous ulcers are the most common type of inflammatory efflorescence of the oral mucosa, with a prevalence of 2% to 10% in Caucasian populations. To treat them properly, physicians should know their clinical appearance and course, conditioning factors, underlying causes, and differential diagnosis. Results Hard, acidic, and salty foods and toothpastes containing sodium lauryl sulfate should be avoided, along with alcohol and carbonated drinks. In Germany, the only drugs that have been approved to treat oral aphthous ulcers are coicosteroids, topical antiseptic/anti-inflammatory agents such as triclosan and diclofenac, and local anesthetics such as lidocaine. Antiseptic agents and local anesthetics should be tried first; if these are ineffective, topical coicosteroids should be used. In severe cases, local measures can be combined with systemic drugs, e.g., colchicine, pentoxifylline, or prednisolone. The efficacy of systemic treatment is debated. Other immunosuppressive agents should be given systemically only for refractory or paicularly severe oral aphthous ulcers due to Adamantiades-Behcet disease [/INST] question: Apthous ulcers are also known as | options: A: Canker sores B: Marjolins ulcer C: Curling s ulcer D: Cushings ulcer | answer: A </s> |
<s>[INST] context: Robert is eleven years old. He loves to watch TV. But for one full year, he did not watch TV at all. What was the reason? Robert's parents said they would give him $500 if he didn't watch TV for a year.
Robert's parents thought he watched too much TV. One day his mother saw a newspaper story about a boy who didn't watch TV for a year. She showed the story to Robert. "It was a joke," his mother said, "I didn't think he would do it." But Robert liked the idea. He turned off the TV right away. He said, "It doesn't matter to me whether to watch TV or not. I just want the money."
At first, Robert's parents were very happy. Robert read the newspaper, played outside, played computer games, and played cards with his mother. But after a while, he got bored. Every evening, he asked his parents, "What are we doing tonight?" Sometimes his mother and father wished he would watch TV, just for one evening. Robert always said, "No, it would cost me money!"
Finally the year was over. Then Robert started watching his favourite TV shows all day long again. Robert got the money from his parents. What does he plan to do with the $500? "I want to buy myself a TV set!" he said. [/INST] question: What is Robert's hobby? | options: A: Playing games B: Reading newspapers C: Talking with his parents D: Watching TV | answer: D </s> |
<s>[INST] context: It was Monday. Mrs. Smith's dog was hungry , but there was not any meat in the house.
Considering that there was no better way. Mrs. Smith took a piece of paper, and wrote the following words on it:"Give my dog half a pound of meat."Then she gave the paper to her dog and said gently:"Take this to the butcher(* person whose job is selling meat)and he's going to give you your lunch today."
Holding the piece of paper in its mouth, the dog ran to the butcher's. It gave the paper to the butcher. The butcher read it carefully, recognized that it was really the lady's handwriting and soon did it as he was asked to. The dog was very happy, and ate the meat up at once.
At noon, the dog came to the shop again. It gave the butcher a piece of paper again. After reading it, he gave it half a pound of meat once more.
The next day, the dog came again exactly at noon. And as usual, it brought a piece of paper in the mouth. This time, the butcher did not take a look at paper, and gave the dog its meat, for he had regarded the dog as one of his customers.
But, the dog came again at four o'clock. And the same thing happened once again. To the butcher's more surprise, it came for the third time at six o'clock, and brought with it a third piece of paper. The butcher felt a bit puzzled . He said to himeself,"This is a small dog. Why does Mrs. Smith give it so much meat to eat today?"
Looking at the piece of paper, he found that there were not any words on it! [/INST] question: Mrs. Smith treated her little dog quite _ . | options: A: cruelly B: fairly C: kindly D: friendly | answer: C </s> |
<s>[INST] context: Do you like to eat sushi ? Many people are afraid to eat it, because they think the bacteria in it might make them sick. However, a new study shows that sea bacteria are good for people. The study finds that a special enzyme from sea bacteria is helpful to humans. It helps people to get more energy from food.
To people's surprise, the enzyme is present only in the Japanese. The Japanese traditionally like to eat food rich in seaweed . And the seaweed is rich in this kind of enzyme.
However, the enzyme isn't present in all the Japanese. During the study, just 5 out of 14 Japanese had the enzyme. All the Americans studied didn't have the enzyme.
"The number is small," said researcher Mirjam Czjzek. "But we can say that this enzyme is present only in the Japanese and not in the North Americans."
Then some people think that maybe other people are able to get the enzyme if they eat a lot of seaweed. The study suggests that they collect uncooked seaweed to make their sushi.
Restaurant sushi is often cooked, which will destroy the enzyme. So, if you want to get that enzyme, you can travel to Japan to have a taste of the real sushi. [/INST] question: Sea bacteria are _ for people. | options: A: helpful B: harmful C: important D: necessary | answer: A </s> |
<s>[INST] context: The juxtaglomerular cells are in the wall of the afferent aeriole, close to the glomerulus. In response to decreased blood pressure, they secrete renin, an enzyme that conves angiotensinogen to angiotensin I. Angiotensin conveing enzyme, found in the lungs, conves angiotensin I to angiotensin II. Angiotensin II increases peripheral vascular resistance directly and stimulates aldosterone secretion, resulting in increased reabsorption of sodium and water in the distal convoluted tubules. The afferent aeriole carries blood from the interlobular aeries to the glomerulus. Filtration of blood occurs in the glomerulus, with the filtrate entering Bowman's capsule. The arcuate aeries are branches of the interlobar aeries of the kidney. The arcuate aeries lie in the coicomedullary junction of the kidney and give rise to interlobular aeries, which enter the coex of the kidney and supply the glomeruli. Kupffer cells are found in the liver, along the sinusoids. They are phagocytic cells that are pa of the reticuloendothelial system. [/INST] question: A hypeensive patient is found to have a paial obstruction of the renal aery due to an atherosclerotic plaque. The resultant decrease in blood flow causes the increased release of an enzyme from which of the following structures? | options: A: Afferent aerioles B: Arcuate aeries C: Juxtaglomerular cells D: Kupffer cells | answer: C </s> |
<s>[INST] context: Early enteral nutrition is recommended in patients predicted to have a prolonged recovery after surgery. The misconception that the entire bowel does not function in the early postoperative period is still widely held. Intestinal motility and absorption studies have clarified the patterns by which bowel activity resumes. The stomach remains uncoordinated in its muscular activity and does not empty efficiently for about 24 hours after abdominal procedures. The small bowel functions normally within hours of surgery and is able to accept nutrients promptly, either by nasoduodenal or percutaneous jejunal feeding catheters or, after 24 hours, by gastric emptying. The colon is stimulated in large measure by the gastrocolic reflex but ordinarily is relatively inactive for 3 to 4 days. Well-nourished patients who undergo uncomplicated surgical procedures can tolerate up to 10 days without full nutritional suppo before significant problems with protein breakdown begin to occur. Enteral nutrition is preferred over parenteral nutrition because of decreased risks of nosocomial infections and catheter-related complications and increased benefit in preventing mucosal atrophy [/INST] question: A 62-year-old woman undergoes a pancreaticoduodenectomy for a pancreatic head cancer. A jejunostomy is placed to facilitate nutritional repletion as she is expected to have a prolonged recovery. What is the best method for delivering postoperative nutrition? | options: A: Institution of enteral feeding the jejunostomy tube after return of bowel function as evidenced by passage of flatus or a bowel movemen B: Institution of enteral feeding the jejunostomy tube within 24 hours postoperatively C: Institution of supplemental enteral feeding the jejunostomy tube only if oral intake is inadequate after return of bowel function D: Institution of a combination of immediate trophic (15 mL/h) enteral feeds the jejunostomy tube and parenteral nutrition to provide total nutritional suppo | answer: B </s> |
<s>[INST] context: Some parents are worrying that their children wouldn't like meals. In fact, most children are usually ready to eat almost anything that is offered to them. A child often likes food unless it is badly cooked. Never ask a child whether he likes or dislikes a food, never discuss likes and dislikes in front of him or allow anybody else to do so . If the father says that he hates fat meat or the mother refuses some vegetables in the child's hearing, he may copy this action. Parents should agree to the fact that he likes everything and he probably will . At meal times, it is a good idea to give a child a small part at one time rather than give him as much as he may eat all together. Do not talk too much to the child during meal times, but let him get on with his food. And do not allow him to leave the table at once after a meal , or he will soon learn to eat his food hurriedly so he can hurry back to the toys in his room . Never coax or make a child eat, or he will think he eats for you. Don't you think it is the same with study ? [/INST] question: A child will probably eat _ if it is not badly cooked. | options: A: only a little of the food B: almost all of the food C: some of the food D: all of the food | answer: D </s> |
<s>[INST] context: LEUKOCYTE RECRUITMENT
• The journey of leukocytes from the vessel lumen to the tissue is a multistep process that is mediated and controlled by adhesion molecules and cytokines called chemokines
LEUKOCYTE ADHESION
• Extravasation is the sequence of events in the journey of leukocytes from vessel lumen to interstitial tissue which include the following steps
> Margination - leukocytes assume a peripheral portion of lumen along endothelial surface
> Rolling - leukocytes adhere transiently, detach and bind again and finally adhere firmly
> Rolling is mediated by Selectins (P, L and E-selectins)
> Firm adhesion is mediated by Integrins (LFA-1. MAC-1, VLA-4, α4β7)
> Pavement - endothelium virtually lined by leukocytes
LEUKOCYTE MIGRATION
• Diapedesis or transmigration
> Leukocyte migration through endothelium
> Occurs mainly in post capillary venules
> Adhesion molecules involved - CD31 or PECAM-1 (platelet endothelial cell adhesion molecule)
CHEMOTAXIS
• Leukocyte migration toward the site of injury
• Locomotion oriented along a chemical gradient
• Chemo-attractants
> Exogenous - bacterial products (most common)
> Endogenous
■ Cytokines, particularly - IL-8
■ Complement, particularly - C5a
■ Arachidonic acid metabolites particularly - LTB4
• Neutrophils predominate in the inflammatory infiltrate during the first 6 to 24 hours
• Neutrophils are replaced by monocytes in 24 to 48 hours
• In Pseudomonas infection - cellular infiltrate is dominated by neutrophils for several days
• In viral infections, lymphocytes may be the first cells to arrive [/INST] question: A10-year-old male child complains of pain and swelling in the left foot. He gives a history of injury while playing. Migration of leukocytes to the site of injury is mediated by | options: A: Cytokines B: Histamine C: Chemokines D: Prostaglandins | answer: C </s> |
<s>[INST] context: When Mr. Jones went to a restaurant one day, he left his coat near the door. There was nothing in the pockets of the coat when he left it, so he was very surprised when he took his coat after his meal and found the pockets full of jewelry .There was a waiter near the door, so Mr. Jones said to him, "Somebody has made a mistake. He has put some jewelry in my coat. Take it, and when he comes back, give it to him." The waiter took it and went away. Suddenly another man came in with a coat just like Mr. Jones's. "I'm sorry ",said this man. "but I made a mistake. I mistook your coat and you have got mine. Please give me my coat and jewelry ."Mr. Jones answered, "I gave the jewelry to the waiter. He will give it to you." Mr. Jones called the manager of the restaurant at once, but the manager said, "We have no waiter here. We only have waitresses." "You gave the jewelry to a thief !" Shouted the other man. "I shall call the police!" Mr. Jones was frightened and paid the man a lot of money for the jewelry. [/INST] question: Who took the jewelry? | options: A: The waiter B: Mr. Jones C: The manager D: The thief | answer: D </s> |
<s>[INST] context: HCV is a flavivirus that is transmitted by parenterally or sexually in the majority of cases; unlike the other members of the Flaviviridae known to infect humans, it is not transmitted by arthropods. Most new HCV infections are subclinical, and 70% to 90% develop into chronic hepatitis. Most HCV chronic cases remain without symptoms but 10% to 20% may develop to chronic active hepatitis and cirrhosis or hepatocellular carcinoma. Mixed cryoglobulinemia and glomerulonephritis complications are not uncommon with HCV (c). HAV (a) is a member of the Enterovirus genus; transmitted fecal-orally, it produces only acute disease. HBV (b), a member of the Hepadnaviridae, is transmitted similarly to HCV; it can produce acute or chronic infections. HDV (d) is a minus-sense RNA virus that can only cause infection in HBV-infected individuals. HEV is a member of the new family Hepeviridae; transmission and disease caused by HEV is similar to that of HAV, although the mortality is higher, especially in pregnant women. [/INST] question: An elderly man had been in several military conflicts during the early 1980s and received blood transfusions for injuries. He recently consulted his physician for what was diagnosed as cryoglobulinemia and glomerulonephritis. Additional testing revealed that he was infected by a flavivirus whose transmission was bloodborne. Which of the following viruses was involved in this infection? | options: A: HAV B: HBV C: HCV D: HDV | answer: C </s> |
<s>[INST] context: In China, safety education is becoming more and more important now. The last Monday in March is for students to learn it at school. It helps students learn more about what they should do to keep themselves safe. What are the accidents at school? Take a look.
Stampedes , earthquakes and fires are the main accidents at school.
A stampede always happens in crowded places. When students around you begin to push, just stand there and try to hold onto something. If you fall down in the crowd, move to one side and protect your head with your hands around.
When earthquakes happen, you can get under a desk quickly and hold on. It'll protect you from falling things. If you are outdoors, find a place away from buildings, trees, and power lines.
When there's a fire, leave the classroom quickly. It's better to put something wet over your mouth and nose. In this way, you won't breathe in smoke. Many people die in a fire, not because of the fire but smoke. It makes them cough and they can't breathe. That's very dangerous! So when you want to get out, you should make yourself close to the floor. Then you can breathe some fresh air. [/INST] question: Stampedes , earthquakes and fires are the main accidents _ . | options: A: at school B: at home C: on the farm D: in the open air | answer: A </s> |
<s>[INST] context: By November 30, 2015, the comedy Goodbye, Mr. Loser had got more than 1,400 million yuan in ticket sales.
It was amazing that a film with common actors who had their first shows in the film got such great success. What's more, the actors were all stage performers and they improved their acting skills by making this film.
The comedy tells about a common middle-aged man who has no job but problems. He seems to be a loser in life and never gets any success. He causes many jokes and is laughed at a lot. And because of his bad luck, he feels upset most of the time. Later, a sudden accident changes his life and he starts to realize how important the family to him.
Goodbye, Mr. Loser was the first movie made by Happy Mahua Pictures. The film came out on September 30, 2015. Because of its great success, the film company became famous overnight.
During the seven-day holiday for National Day in 2015, the ticket sales were just behind the most popular film being shown at the same time-Lost in Hong Kong. [/INST] question: Goodbye, Mr. Loser had got over _ yuan by November 30, 2015. | options: A: 140,000,000 B: 14,000,000 C: 1,400,000,000 D: 14,000,000,000 | answer: C </s> |
<s>[INST] context: Haab's striae are horizontal breaks in the Descemet membrane associated with congenital glaucoma. It is named after Otto Haab. Haab striae are curvilinear breaks in Descemet's membrane, resulting acutely from stretching of the cornea in primary congenital glaucoma. They are typically oriented horizontally or concentric to the limbus in contrast to Descemet's tears, resulting from birth trauma, that are usually vertical or obliquely oriented. differential diagnosis Band-like structures, clinically similar to Haab's striae, occur in posterior polymorphous dystrophy (PPMD) and are often confused with them. The difference in clinical appearance based on difference in histopathology allows a clear differentiation. The edge of Haab's striae are thickened, curled, and secondarily proliferate Descemet's membrane, while the area between the edge is thin and smooth. Posterior polymorphous dystrophy bands are the exact opposite. The band is a thickening of Descemet's membrane between the edges with thinner, more normal Descemet's membrane outside of them. PPMD bands may be associated with typical vesicles or appear as the only sign of dystrophy, even in the eyes of patients with a known family history. [/INST] question: Haab's striae is seen in? | options: A: Trachoma B: Congenital glaucoma C: Scletitis D: Cataract | answer: B </s> |
<s>[INST] context: Oceanography has been defined as "The application of all sciences to the study of the sea".
Before the nineteenth century scientists with an interest in the sea were few and far between. Certainly Newton considered some theoretical aspects of it in his writings, but he was reluctant to go to sea to further his work.
For most people the sea was remote, and with the exception of early intercontinental travelers or others who earned a living from the sea, there was little reason to ask many questions about it, let alone to ask what lay beneath the surface. The first time that the question "What is at the bottom of the oceans?" had to be answered with any commercial consequence was when the laying of a telegraph cable from Europe to America was proposed. The engineer had to know the depth profile of the route to estimate the length of cable that had to be manufactured.
It was to Maury of the US Navy that the Atlantic Telegraph Company turned, in l853, for information on this matter. In the 1840s, Maury had been responsible for encouraging voyages during which soundings were taken to investigate the depths of the North Atlantic and Pacific Oceans. Later, some of his findings aroused much popular interest in his book The Physical Geography of the Sea.
The cable was laid, but not until 1866 was the connection made permanent and reliable. At the early attempts, the cable failed and when it was taken out for repairs it was found to be covered in living growths, a fact which defied contemporary scientific opinion that there was no life in the deeper parts of the sea.
Within a few years oceanography was under way. In 1872 Thomson led a scientific expedition, which lasted for four years and brought home thousands of samples from the sea. Their classification and analysis occupied scientists for years and led to a five-volume report, the last volume being published in l895. [/INST] question: The proposal to lay a telegraph cable from Europe to America made oceanographic studies take on _ . | options: A: a business aspect B: a military aspect C: an academic aspect D: an international aspect | answer: A </s> |
<s>[INST] context: Endometrioma Another clinical based question with insufficient information to make any confirm diagnosis. At the best we can try to make the most probable diagnosis. Let's first see CA-125. CA-125 This is a non-specific tumor marker. Cut off level of CA-125 is < 35 U/ml. Ca 125 levels, as described above, can be raised in all the four options, so not very helpful in reaching a diagnosis. But if we weigh CA-125 level in terms of significance then it is least significant in tuberculosis as it is neither used for diagnosis nor for follow-up in tuberculosis. Palpable mass may be present in all the four conditions. Infeility is a feature of both endometriosis and tuberculosis. But for ovarian cancers infeility is a risk factor, not a feature or presenting symptom. Coming to Age: Patient is 35 yrs old. Age of 35 yrs ours endometrioma most. Peak incidence of invasive epithelial ovarian cancer (most common ovarian cancer) is at 56-60 yrs of age and for border line tumor average age is 46 yrs approximately (Novak). Patients with tuberculosis are in their twenties commonly, the maximum age incidence at diagnosis being 28 yrs. So on the basis of age and infeility, the most probable diagnosis would be endometrioma [/INST] question: A 35-yr old woman presents with primary infeility & palpable pelvic mass. Her Ca-125 level is 90 U/ml. diagnosis is aEUR' | options: A: Ovarian Ca B: Endometrioma C: Tuberculosis D: Borderline ovarian tumor | answer: B </s> |
<s>[INST] context: Hungry for Change is part of a growing movement of people who want to stop _ throughout the world . They want to make certain that people in famine areas can protect themselves from the effects of future droughts . They also want to make certain that enough help is quickly available for emergencies in all parts of the world .
Hungry for Change has helped to raise millions of pounds for famine relief . It has attracted a great deal of newspaper publicity for its relief work . It has also been successful in persuading the government in prefix = st1 /Britainto increase its aid budget by several million pounds and carry out new research into improved crops . While Hungry for Change works in Britain for an end to poverty and famine in the world , Oxfam is helping to get over the fear of famine in such countries as Ethiopia and Sudan with long-term development projects .
In North West Darfur , Sudan , Oxfam is helping to increase food production .
In Nile Province,Sudan, Oxfam is planting trees in order to provide fuel and shelter , and to protect the soil . It is a faraway area , where rainfall is poor and conditions for agriculture and the forests are difficult .
In Arba Minch,Ethiopia, Oxfam is supporting a project to supply clean water to villages . Clean water will reduce the risk of diseases, especially among children . [/INST] question: Hungry for Change and Oxfam are two_. | options: A: branch offices B: churches C: hospitals D: organizations | answer: D </s> |
<s>[INST] context: There is no excuse for not doing yourassignments . If you can't come to school, you should call your teacher or your classmate and ask about homework. It is yourresponsibility to find out what homework you have missed. It is not the teacher's job to remind you of the missed assignments.
You must not be absent on a test day. If you are seriously ill, call and let the teacher know you will not be there for the test. If your teacher allows amake-up test ,you should take the test within one or two days after you return to class. Serious illness is the only reason for missing a test.
Be on time! It is impolite to be late. Also, it bothers other students. If you must come in late, be sure to do it quietly. Have your books and papers out of your bag before you come into the room. Then go to your seat and sit down quietly. In the USA, it is not necessary to knock before you enter the classroom. Most teachers will give you a low grade if you are often late.
In America, you should call your teacher by his or her last name instead of " teacher". Also you should use Mr, Miss, Ms or Mrs before the last name ( such as Mrs Smith or Mr Jones). This is polite. The teacher will tell you the title that he or she likes. It is impolite in the USA to eat, drink or chew gum during class. Don't do these until the break. Also, removing your shoes in the classroom is not polite. [/INST] question: What should you do if you miss a class? | options: A: Give an excuse for missing the assignments B: Tell the teacher you can't come to school or do the assignments C: Ask your teacher to remind you of the missed assignments D: Call your teacher or your classmate to find out what assignments were given | answer: D </s> |
<s>[INST] context: Rapid fluid administration is often the key to successful trauma resuscitation. Some of the important factors affecting the rate of fluid resuscitation include the diameter of the intravenous tubing, the size and length of the venous cannulae, the fluid viscosity, and the site of administration. According to Poiseuille's law, flow is proportional to the fourth power of the radius of a catheter and inversely proportional to its length. Therefore, the shorter a catheter and the larger its diameter, the faster one can infuse a solution through it. Central venous placement alone does not assure rapid flow. Importantly, the diameter of the intravenous tubing employed may be the rate-determining factor in fluid delivery: blood-infusion tubing allows twice the flow of standard intravenous tubing and should be used when rapid fluid resuscitation is needed. Any patient who is suspected of having a major abdominal injury should immediately have at least two short, large-bore (16-gauge or larger) intravenous cannulae placed in peripheral veins. Longer, smaller catheters, such as standard 18-gauge central venous catheters, may take more time to place and will have lower flow rates. Once fluid resuscitation is under way, one may elect to place an 8- or 9-French pulmonary artery catheter-introducer via a central venous approach for further volume administration, as well as for measurement of central venous pressure or for Swan-Ganz catheter insertion. Lower-extremity venous cannulae, placed by saphenous vein cutdown or percutaneously into the femoral veins, are no longer advised as primary access for patients with abdominal trauma, since possible disruption of iliac veins or the inferior vena cava will render volume infusion ineffective. Studies have demonstrated that the flow rate of cold whole blood is roughly two-thirds that of whole blood at room temperature. Diluting and warming the blood by "piggybacking" it into infusion lines that are delivering crystalloid will decrease the blood's viscosity, enhance flow, and minimize hypothermia. [/INST] question: Rapid fluid resuscitation of the hypovolemic patient after abdominal trauma is significantly enhanced by which of the following? | options: A: Placement of long 18-gauge subclavian vein catheters B: Placement of percutaneous femoral vein catheters C: Bilateral saphenous vein cutdowns D: Placement of short, large-bore percutaneous peripheral intravenous catheters | answer: D </s> |
<s>[INST] context: A 34-year-old mother has spoken of how she woke up thinking she was 15 years old and living in 1992.
Naomi Jacobs, from Manchester, was convinced she was still a teenager. In her mind, John Major was Prime Minister and George Bush Sr. was running the White House. She also showed how she screamed when a boy appeared and called her "Mum". Mobile phones and e-mails were puzzling and Google, Facebook and YouTube sounded like made-up words, she said.
Ms. Jacobs, who had no memory of the years, was told by doctors that she had Transient Global Amnesia (TGA). She has now written a book about the experience which happened in 2008.
"I fell asleep in 1992 as a brave, very confident know-it-all-15-year-old, and woke up as a 32-year-old single mum living in a rented house," Ms. Jacobs said. "The last thing I remember was falling asleep in my bed, dreaming about a boy in my class. When I woke up, I looked in the mirror and had the fright of my life when I saw an old woman with wrinkles staring back at me. Then a little boy appeared and started calling me Mum. That's when I started to scream. I didn't know who he was. I didn't think he was much younger than I was, and I certainly didn't remember giving birth to him. I began sobbing uncontrollably. I just wanted my mum. I couldn't get my head around going to bed one night and waking up in a different century."
TGA is a rare type of amnesia which can occur suddenly, affecting around three people per 100,000 each year. Fortunately, permanent memory loss is rare. Ms. Jacobs' memory started to return after eight weeks.
Some people who often suffer from migraines also appear to be more likely to have TGA. The cause of TGA is unknown. Some think that it may be caused by a temporary cut of blood flow to parts of the brain involved in memory. [/INST] question: When a little boy came to call her "Mum", Naomi Jacobs was _ . | options: A: excited B: frightened C: worried D: embarrassed | answer: B </s> |
<s>[INST] context: One day, John Randolph rode on his horse to a town many miles from his home. The road was strange to him, so he traveled very slowly. When the night fell, he stopped at a nice roadside inn for accommodation .The innkeeper welcomed him.
A fine supper was prepared. The innkeeper talked about the weather, the roads, the crops. However, his guest ate silently. Next morning after breakfast, Mr. Randolph paid his bill and was ready for his journey. Leading his horse to the door, the innkeeper said, "Which way will you travel, sir?" Mr. Randolph looked at him and answered, "I've paid you my bill. Should I pay you anything more? I travel the way I wish to go."
But not far from the inn, to his surprise, there were two ways. He searched for a while but there was no sign to help him. The innkeeper was still standing by the door. He called to him: "My friend, which road leads to Lynchburg?" The innkeeper answered, "Sir, you have paid your bill and don't owe me a cent. Travel the way you wish to go. Good-bye!"
As bad luck would have it, Mr. Randolph took the wrong road. Though out of his way, he lost much time, all because of his rudeness. [/INST] question: John Randolph traveled slowly because | options: A: it was rainy B: the horse was tired C: the road was strange D: the time was early | answer: C </s> |
<s>[INST] context: Canada, the second largest country in the world, lies in the north of America. The population of Canada is about 29 million and the capital is Ottawa. The country covers about 9,980,000 square kilometers and six of the world's 24 time areas as well.
There are two official languages spoken in Canada: French and English. Many people can speak both English and French. More than 60% of Canadians speak English as their language. About 25% of the Canadians speak French. In one province of Canada where French is the common language, the programmes on TV and radios as well as the teaching in schools are all in French. Today, Chinese has become the first inofficial language in Canada.
Canada's climate is not as cold all year around as some may believe. In winter, temperatures fall below freezing point throughout most of Canada. In summer, the southern provinces often experience high levels of temperatures that can reach over 30degC regularly. The weather in Canada is just like the weather in China. It is rather cold in the north while it is fairly warm in the south. Winters in the north last long with snow for half a year. As the cold northern climate, only one-fifth of the land is suitable for farming.
As it is known to all, Canada has one-third of the world's supply of fresh water. It has many great lakes. There are five great lakes in the south. And there are many others, especially in the north. It is also rich in natural resources, such as coal, oil, natural gas of which Canadians make use to produce energy.
People of northern Canada are called Inuit , who came from Asia and settled in Canada about 4,000 years ago. They used to travel around from place to place with teams of dogs which pulled their baggage. Now, they seldom move. There are about 2,500 Inuit in all. The government has started a new school project in which Inuit teach their own young children. So it is hoped that the way of Inuit life will be kept alive for more centuries. [/INST] question: How many people are there living in Canada? | options: A: About 24 million B: About 29 million C: About 25 million D: About 9,980,000 | answer: B </s> |
<s>[INST] context: Goodpasture syndrome
Goodpasture syndrome is a rare condition characterized by the rapid destruction of the kidney and diffuse pulmonary hemorrhage.
It is an autoimmune disease characterized by the presence of circulating autoantibodies targeted against basement membrane of lung and kidney.
These antibodies are directed against the noncollagenous domain of the α -3 chains of type IV collagen (collagen of basement membrane).
The antibodies initiate an inflammatory destruction of the basement membrane in kidney glomeruli and lung alveoli.
In Goodpasture syndrome, the immune reaction is type II hypersensitivity.
Morphological changes
I. Lung
The lungs are heavy, with areas of red-brown consolidation.
There is focal necrosis of alveolar walls associated with intraalveolar hemorrhages.
Alveoli contain hemosiderin-laden macrophages.
Linear deposits of immunoglobulins along the basement membranes of the septal walls.
II. Kidney
Diffuse proliferative rapidly progressive glomerulonephritis.
Focal necrotizing lesion and crescents in >50% of glomeruli.
Linear deposits of immunoglobulins and complement along the glomerular basement membrane.
Clinical manifestations
Occur typically in young males.
Most cases begin clinically with respiratory symptoms, principally hemoptysis.
Soon, manifestations of glomerulonephritis appear and typically present as nephritic syndrome → hematuria, nephritic urinary sediment, subnephrotic proteinuria, rapidly progressive renal failure.
The common cause of death is renal failure. [/INST] question: Goodpasture's syndrome is characterized by - | options: A: Necrotising hemorrhagic interstitial pneumonitis B: Alveolitis C: Patchy consolidation D: Pulmonary edema | answer: A </s> |
<s>[INST] context: Many homes have cameras to protect them from danger. The cameras can tell the owners if someone has entered. But the cameras do not know whether the person is a family member, a friend, a postman or a criminal .
But a new camera made by a French company can recognize faces. It can tell parents at work that their children have returned from school, or that the mail has been sent to their home. It can also tell them if a stranger has entered their home. When family members enter a home, the smart camera "recognizes" them and sends information to the owner's phone. The owner can choose to see the video then or later. But if an unknown person enters a home, the camera will send a warning sound on the owner's phone.
This is what happened recently to a smart home camera owner named Damien. He lives in Paris.
"On a Friday I was at work, having a big monthly meeting when my phone moved. At first I told myself 'Oh, it must be a wrong warn,' but my phone was telling me there was a face that the camera did not recognize. Something was happening in my house!"
"I saw a person I did not know with his shoes on, which is not allowed in my apartment . I watched it on the video. I felt quite surprised. I hurried back home as fast as possible and called the police on the way. Thanks to the smart camera, the criminal was caught soon," said Damien. [/INST] question: The new smart camera is different from the ones in many homes because it can _ . | options: A: protect the owner B: help a school child C: recognize faces D: call the police | answer: C </s> |
<s>[INST] context: In 50 years of traveling, Colin McCorpuodale has visited every country in the world except three. And everywhere he goes, he sends himself a postcard. He always chooses a postcard with beautiful scenery . Usually he writes just a short message to himself. However, he wrote an interesting story on his latest one, from the Malians Island.
Mr. McCorpuodale lives in London. On one of the walls in his room, you can see a large map of the world. There are hundreds of little red pins stuck in it. "These pins mean a lot to me." says Mr. McCorpuodale, "I follow the rule. I'm allowed to stick one in only if I've been in a place for more than 24 hours."
Naturally, Mr. McCorpuodale has his favorite places. New Zealand, he describes as "a wonderful country". About China, he says, "This is the country in the world which is completely different. There is no European influence."
Wherever he goes, Mr. McCorpuodale takes with him a photo of his wife, a candle, a shirt with a secret pocket and a pen.
So why does he do it? For the postcards or the travels? Mr. McCorpuodale laughs, "Neither. Only for the meaningful life." [/INST] question: What did Mr. McCorpuodale write about on his latest postcard? | options: A: Malians Island B: An interesting story C: Beautiful scenery D: His favorite places | answer: B </s> |
<s>[INST] context: American parents generally can choose any name they want for their children. They may choose a name because it honors a family member. Or they may choose a name just because they like it.
A website called Baby Center lists some unusual names given to American babies born last year. Some were named for characters in old stories, such as Hero, Thor and Ulysses. Other people named their babies after kinds of food, like actress Gwyneth Paltrow. She named her daughter Apple. Other people named their babies Banana, Pumpkin and Cookie.
Still some babies were named for places. These included Brazil, India and Rome. Some parents used names of famous people from history such as Newton and Hannibal. Other parents named their babies after flowers or the weather. These babies were named Buttercup, Iris, Sunshine and Thunder.
Recording artists and movie actors influence some parents' choices of names. Babies were named Beyonce, Charlize, Reda, Pierce, Shajira and Whitney. Movie actors themselves often give their babies unusual names. For example, Angelina Jolie and Brad Pitt named their baby daughter Shiloh. Tom Cruise and Katie Holmes named their little girl Suri.
Some American parents do not want unusual names. They want their baby's name to honor their religious faith. Such names include Abraham for boys or Sarah for girls. And many people give their babies the same name as a family member or good friend.
The United States Social Security Administration once published a list of the most popular names for American girls and boys born. Many of the top ten boys, names are from the Jewish and Christian Bibles. [/INST] question: How did American parents usually name their children? | options: A: In a way they please B: In a scientific way C: In a careless way D: In a common way | answer: A </s> |
<s>[INST] context: Symptoms Rheumatic fever symptoms vary. You can have few symptoms or several, and symptoms can change during the course of the disease. The onset of rheumatic fever usually occurs about two to four weeks after a strep throat infection. Rheumatic fever signs and symptoms -- which result from inflammation in the hea, joints, skin or central nervous system -- can include: Fever Painful and tender joints -- most often in the knees, ankles, elbows and wrists Pain in one joint that migrates to another joint Red, hot or swollen joints Small, painless bumps beneath the skin Chest pain Hea murmur Fatigue Flat or slightly raised, painless rash with a ragged edge Jerky, uncontrollable body movements (Sydenham chorea) -- most often in the hands, feet and face Outbursts of unusual behavior, such as crying or inappropriate laughing, that accompanies Sydenham chorea Complications Inflammation caused by rheumatic fever can last a few weeks to several months. In some cases, the inflammation causes long-term complications. Rheumatic fever can cause permanent damage to the hea (rheumatic hea disease). It usually occurs 10 to 20 years after the original illness, but severe cases of rheumatic fever can cause damage to the hea valves while your child still has symptoms. Problems are most common with the valve between the two left chambers of the hea (mitral valve), but the other valves can be affected. The damage can result in: Narrowing of the valve. This decreases blood flow. Leak in the valve. A leaky valve causes blood to flow in the wrong direction. Damage to hea muscle. The inflammation associated with rheumatic fever can weaken the hea muscle, affecting its ability to pump. Damage to the mitral valve, other hea valves or other hea tissues can cause problems with the hea later in life. Resulting conditions can include: An irregular and chaotic heabeat (atrial fibrillation) Hea failure ref : harrisons 21st ed [/INST] question: An 60 yr old unvaccinated came to the OPD with fever and red eyes O/e the following type of rash was seen body of the pt . What is the most likely complication expected with this condition | options: A: myocarditis B: nephritis C: pancreatitis D: orchitis | answer: A </s> |
<s>[INST] context: New research is strengthening evidence that eating vegetables may be some of the best health advice. A study of 500, 000 Americans has found that just one extra serving of fruit or vegetables a day may reduce the risk of developing head and neck cancer. Many studies have shown that diet plays a role in cancer. Cancer experts now believe that up to two-thirds of all cancers come from lifestyle such as smoking, diet and lack of exercise. Tobacco and alcohol use increases the risk of head and neck cancer, which affects the mouth, nose, sinuses and throat.
Researchers at the National Cancer Institute asked men and women aged 50 and older about their diets, then followed them for five years to record all diagnoses of head and neck cancer, the sixth-leading cause of cancer-related death worldwide.
The study found eating six servings of fruit and vegetables per day per 1, 000 calories cut the risk of head and neck cancer by 29 percent compared to eating one and a half servings. An adult needs around 2, 000 calories a day. "One more serving of fruit or vegetables per 1, 000 calories per day reduced head and neck cancer risk by 6 percent,"said Neal Freedman, a cancer prevention fellow at the NCI.
A second study in 183, 000 people of California and Hawaii found a diet high in flavonols might help reduce pancreatic cancer risk, especially in smokers. Flavonols are common in plants but highest in onions, apples, berries, kale and broccoli.
The study found that people who ate the most flavonols reduced risk of developing pancreatic cancer by 23 percent than those who ate the least. [/INST] question: All the following are the causes of the head and neck cancer EXCEPT _ . | options: A: drinking B: smoking C: lacking exercise D: eating an apple | answer: B </s> |
<s>[INST] context: GOLDEN, British Columbia (AP)---A 3-year-old girl found alive in the upside down wreckage of an airplane survived because she was _ in a car seat, rescuers said. They said they knew she was OK when she cried for her teddy bear.
Sunday's crash killed Kate Williams' pilot-grandfather, Allen D. Williams, 65, and another passenger, authorities said. The plane was found nose down and turned over in the icy water at the edge of a riverbank in the mountains of southeast prefix = st1 /British Columbia.
"What saved her life was being strapped into that car seat," said Mike Plonka, a member of the search-and-rescue team. "You could see that she was very frightened. Her big concern at the time was her little teddy bear. She didn't want to leave without it. . . " "She was just pointing at it and calling it 'Baby'. " he said Monday. The girl suffered head injuries but was reported as stable, hospital officials in Golden said. She was reunited with her parents.
Police said the Cessna 172 was on its way to Edmontonwhen it took off from Golden around 1 pm Sunday into low clouds and snow. Visibility was poor. An hour later, the Search and Rescue Centre in Victoria picked up the plane's emergency signal from somewhere near the BlaeberryRiver.
A team using a hand-held beacon locator found the wreckage, and two military search and rescue technicians--Sgt. Scott Elliston and Master Cpl. Bruno Lapointe---landed nearby in a helicopter. As they checked for survivors, they discovered the girl alive but surrounded by debris in the back of the plane. The two soldiers tried to remove her from the wreckage, but she made it clear she didn't want to leave without her teddy bear.
"I got her out and I handed her to Bruno. She was calling out for her teddy bear. I picked up the teddy bear to give it to her but it was covered with snow. She wasn't too happy that it was covered with snow so I brushed it off. "Elliston said.
Williams was CEO and founder of Edmonton-based A. D. Williams Engineering Inc. The passenger who was killed, Steven T. Sutton, was chief financial officer. The two had been attending a business meeting in Golden. The cause of the accident was under investigation. [/INST] question: How many passengers died in the accident? | options: A: 1 B: 2 C: 3 D: 4 | answer: B </s> |
<s>[INST] context: Most people like buying things by touching them on a store shelf. Many people begin to feel some goods as theirs when they touch them. They have "mine, mine, mine" feeling as little as 30 seconds after touching an object .
In a study, some people were shown a cheap coffee cup, and were allowed to hold it for 10 seconds or 30 seconds. They were then allowed to buy it in either a closed or an open place. The people knew the real price of the cup before they began to buy.
If people hold the cup for a longer time, he will pay more for it. In fact, people hold the cup for 30 seconds pay more than the others. "The amazing part of this study is that people can become almost attached to something like a cup." said James Wolf,"By touching the cup and holding it in their hands, they begin to feel the cup is theirs. Once they begin to feel it as theirs, they are willing to keep it."
Many businessmen use this way to sell their things. For example, car sellers send the buyers out on test drives and pet shop owners encourage people to play with the dogs in the window. When you are testing out new cars, you are going to buy it at once. But you can do better if you get ready for it. [/INST] question: Many people want to buy something which they can _ by themselves. | options: A: see B: touch C: hear D: look | answer: B </s> |
<s>[INST] context: Houseplants clean the air and brighten a room. Occasionally, they drive us mad as we wonder how exactly we managed to kill yet another "unkillable" houseplant. (In that way, they provide great lessons in perseverance as well!) But it looks like there's one more great reason to grow houseplants: their presence in your workspace might actually make you smarter.
According to a recent study published in The Journal of Environmental Psychology, just having plants in your work space is enough to increase your attention span. An increase in attention span means that we're able to remember more of what we read. To test the hypotheses, the study's authors gave subjects a Reading Span Task, which requires reading sentences aloud, then remembering the last word in each sentence. This requires reading, memorization, and recall abilities, and switching between the three.
The researchers had their entire test pool complete Reading Span Tasks to get a baseline reading. Then they moved some of the people to a room with no plants, and others to a room that had four plants around the desk. They were all asked to repeat the Reading Span Tasks, and the people who worked near a plant improved overall, while those without plants stayed roughly the same.
Beauty, fresh air, the joy of caring for another living thing -- all great reasons to have a few houseplants around. If they help increase attention spans, all the better! [/INST] question: The study shows that growing houseplants can_. | options: A: clean the air B: make the house beautiful C: increase attention spans D: have the joy of caring | answer: C </s> |
<s>[INST] context: (Increased fetal diastolic flow in the middle cerebral artery with absent diastolic flow in the aorta)(648- D)Doppler - direction as well as velocity of blood flow can be measured by doppler ultrasound.* Reduced diastolic flow indicates high resistance in the downstream vessel and low tissue perfusion. Presence of'notch' in the early diastolic waveform also indicates high resistance in the downstream vessel and low tissue perfusion.* *Presence of notch in uterine artery when confirmed bilaterally at 24 weeks indicates the possible development of preclampsia and fetal growth restriction* Absent end diastolic flow in the umbilical artery was associated with 16% fetal death rate and reversed diastolic flow with 50% fetal death rates.* * Increased fetal diastolic flow in the middle cerebral artery (centralization of flow) with absent diastolic flow in the aorta implies fetal acidemia** Abnormal venous waveforms (ductus venosus, IVC) indicates fetal cardiac dysfunction (failure)Single umbilical artery - It is more common in twins and in babies bom of diabetic mothers or in polyhydramnios.* It is frequently associated with congenital malformation of the fetus (10-20%). Renal and genital anomalies, Trisomy 18 are common, (228-D)* There is increased chances of abortion, prematurity, IUGR, and increased perinatal mortality. [/INST] question: Increased acidosis and hypoxaemia is seen in | options: A: Normal doppler wave form B: Increased fetal diastolic flow in the middle cerebral artery with absent diastolic flow in the aorta C: Presence of the 'notch' in the uterine artery D: Absent umbilical artery | answer: B </s> |
<s>[INST] context: On February 3rd, 1949, New York Harbor was an exciting place. Many people were there to greet a ship from France. On the ship were 49 French railroad boxcars filled with gifts from the people of France to the people of America. These boxcars were from the famous Merci Train(Merci:a French word meaning "thank you").
After World War II, a lot of factories, roads and farms in France had been destroyed. Many French people had no jobs or money and had little to wear and little to eat. In the winter of 1947, a train was sent across the United States, stopping in cities and towns along the way. At every stop, people gave whatever they could. Factories gave clothing and medicine. Farmers gave food. Families gave money. Even school children gave away their pocket money. All the things were then taken to France by ship.
By 1949,the French had begun to recover from the war. The Merci Train was their way of saying "thank you" to America. French people had filled the boxcars with gifts. Most of _ were personal, like hand-made toys, children's drawings, or postcards. But the boxcars themselves were perhaps the most meaningful of the gifts. On each car, the French people had painted the pictures of all their 40 provinces. with an American eagle on the front. The boxcars were taken to each state of America, where they were warmly greeted.
Now many of the states still keep their boxcars. Gifts sent by the French people can still be seen in some museums. The Merci Train came out of the war, but it now reminds the world that countries can also work together in peace. [/INST] question: Many people crowded at New York Harbor on February 3rd, 1949 to _ . | options: A: welcome the Merci Train B: meet their families C: have a big party D: start a trip by ship | answer: A </s> |
<s>[INST] context: When Lew Alcindor was 13, and obviously still growing, a group of schools began offering him scholarships . The Alcindors decided to send their only child to Power Memorial Academy, a small school on Manhattan's West Side.
At Power, Alcindor came under the control of Coach Jack Donohue, a strict young an who already gained his fame as one of the best coaches in the city.Donohue brought Alcindor along slowly.As a first-year student, the boy was not able to do much but wave his long skinny arms and shoot a basket now and then.But by the second year, when he was 15 years old and nearly 7 feet tall, Alcindor was quick and skillful enough to make the high school All-American team and to lead Power to an undefeated season.
From then on he simply got better.Some rival coaches used to take their teams quickly away from the floor before Power warmed up so that their players would not see him any sooner than they had to.Wearing size 16 D shoes and sucking a lollipop , Alcindor would loosen up by starting his leaping lay-ups .Then he would casually shoot the ball with either hand, to the delight of the fans.
When reporters and photographers began to follow Alcindor closely, Donohue protected his boy firmly.He simply ordered Lew to talk to no member of the press, and this suited Lew fine.He was not comfortable talking to grown-ups, perhaps because he towered over them.Discouraged photographers began following him in secret as though he were an easily-frightened giraffe.Once after ducking into a subway to escape, Alcindor told a friend that it was all becoming like policemen and robbers."People want you not for yourself," Donohue warned him, "but because you're a basketball player.Don't forget that." [/INST] question: Many schools offer Alcindor scholarships because _ . | options: A: he was young B: he was hardworking C: he was tall for his age D: he was skillful at playing basketball | answer: C </s> |
<s>[INST] context: Malingering/Nonorganic hearing loss (also called pseudohypacusis)
Ocassionally patients wilfully or subconsciously exaggerate their hearing loss.
This is functional hearing loss or pseudohypacusis or malingering
– The signs in the test behavior that suggest functional component include:
a. Inconsistent responses
b. Significant differences between the threshold obtained using ascending and descending administration of test stimuli
c. A discrepancy of > 8 dB between the SRT (speech reception threshold) and the pure tone average of 500–2000 Hz
d. Positive Stenger test
Stenger Test
It is used to identify unilateral or asymmetrical functional hearing loss. It is based on the concept that when both ears are stimulated simultaneously by a tone equal in frequency and phase, the auditory percept is lateralized to the ear with better hearing.
If speech stimulus is used in Strenger test it is k/a Speech Stenger test or modified Stenger test.
Other objective tests which can diagnose functional involvement are:
––acoustic reflexes: Pt saying hearing loss but normal acoustic reflex indicates NOHL
––auditory brainstem response
––otoacoustic emission
Also Know
Other tuning fork tests which can be used to detect malingering but are now outdated are:
Teel’s test
Lombard’s test
Chamini-Moos test
Gault test [/INST] question: Which one of the following test is used to detect malingering - | options: A: Stenger's test B: Buinge's test C: Weber 's test D: Rinne's test | answer: A </s> |
<s>[INST] context: Many people go to school for a good education. They learn languages, history, maths and other lessons. School education is very important and useful. Yet no one can learn everything from school. No matter how much a teacher knows, he cannot teach his students everything they want to know. His work is to show his students how to learn. He teaches them how to read and how to think. So, much more is to be learned outside school by the students themselves. It is always more important to know how to study by oneself. It is quite easy to learn something in a language or a formula in maths,but it is difficult to use a formula in finding the answer to a maths problem . Great inventors do not get everything from school but they can invent many things and change the world a lot. Though Thomas Edison invented many things he didn't have much school education. How do they do all these? Because they know how to study. A lot of things are not taught in the classroom. They get knowledge from books outside school. They work hard all their lives, and the most important thing is that they know how to use their head. [/INST] question: What do many people go to school for? | options: A: To make friends B: To get everything C: To study by themselves D: To get a good education | answer: D </s> |
<s>[INST] context: Fetal exposure to an antibiotic depends on many factors such as gestational age, protein binding, lipid solubility, pH, molecular weight, degree of ionization, and concentration gradient. Some antibiotics are even concentrated in the fetal compartment. Tetracycline is contraindicated in all three trimesters. It has been associated with skeletal abnormalities, staining and hypoplasia of budding fetal teeth, bone hypoplasia, and fatal maternal liver decompensation. Sulfonamides are associated with kernicterus in the newborn. They compete with bilirubin for binding sites on albumin, thereby leaving more bilirubin free for diffusion into tissues. Sulfonamides should be withheld during the last 2 to 6 weeks of pregnancy. With prolonged treatment of tuberculosis (TB) in pregnancy, streptomycin has been associated with fetal hearing loss. Its use is restricted to complicated cases of TB. Nitrofurantoin can cause maternal and fetal hemolytic anemia if glucose- 6-phosphate dehydrogenase deficiency is present. Chloramphenicol is noted for causing the gray baby syndrome. Infants are unable to properly metabolize the drug, which reaches toxic levels in about 4 days and can lead to neonatal death within 1 to 2 days. [/INST] question: Select the antibiotic most frequently associated with the Fetal high-tone hearing loss (SELECT 1 ANTIBIOTIC) | options: A: Tetracycline B: Streptomycin C: Nitrofurantoin D: Chloramphenicol | answer: B </s> |
<s>[INST] context: Cameron thought of himself as merely organized. He certainly did not consider that he took great pains over anything, he did just enough to get it right. Exactly right, of course, for as he was fond of telling his staff, "if it's not exactly right, it's wrong". Occasionally a worker might be sad on hearing these words, because it meant another hour or so of going over the same bit of work, correcting the mistakes which Cameron had patiently pointed out. And doing the corrections exactly right of course.
Strangely enough, his department had the reputation for performing the highest quality work in the company, and it was seen, and not only by those who worked in the department, as a sort of elite unit. Those programmes that had to work first time, straight out of the box, Cameron's men got those. "It's mission critical--give it to Cameron" was almost a catch-phrase with his team.
It helped that Cameron was not merely particular about things. He wanted things done just so, not because of a personal taste, but because he had discovered through patient experimentation that this was the best way for it to be done.
In Cameron's dictionary, "Take as long as you want" meant that you could work on your task not just in office hours, but that evening, and late into the early hours of the following morning if you so desired. But the project had to be in by its completion date, and yes, done exactly right. Or you did it again.
But he would always be regarded, and not least by himself, as someone who had failed to meet requirements, one of those _ . You had to face it, if you were not working for Cameron, you were second best. So when word got out that Cameron had messed up, big time, the news was greeted with a mixture of sympathy, and entire relief that this perfection too was human. [/INST] question: Cameron was a _ . | options: A: software programmer B: a chief scientist C: quality controller D: head of department | answer: D </s> |
<s>[INST] context: Have you ever heard of e-waste(electric waste,), which can be produced every day? How do you deal with your computers, MP4 players and mobile phones when they're broken or you want a new one?
Most people just throw them away. With the development of electric industry, e-waste pollution has become a serious problem. According to the United Nations, in 2014, people around the world produced 41.8 million tons of e-waste and only recycled 6.5 million tons. The US was the biggest waster, producing 7.1 million tons. China came second, with 6 million tons.
It's important to pay attention to e-waste. It can either be valuable or harmful , depending on how we deal with it. E-waste is a valuable urban mine . The value of the metals, like gold and silver in the waste around the world, is amazing. And the metals can be reused. But if people throw them away, the toxic chemicals can get into the earth or air, effecting the environment and people's health.
Apple, for example, now recycle people's used products in China when they are buying new ones. The company will test and repair the used ones and sell them at lower prices. To help reduce e-waste, we can also take computers and phones to see if companies offer recycling programs. [/INST] question: The following can become e-waste EXCEPT _ . | options: A: computers B: mobile phones C: plastic bags D: MP4 players | answer: C </s> |
<s>[INST] context: Chronic interstitial nephritis with VUR Information provided in the question:- Hypeension ARF (increased urea and creatinine) Pvuria, Absence of hematuria Mild proteinuria These features suggest chronic interstitial disease with vesicoureteric reflux. -Vescioureteric reflux in children may leas to chronic interstitial nephritis. - In children chronic interstitial disease commonly occurs as a result of underlying congenital renal disease such as obstructive uropathy or vesicoureteric reflux. - Presence of urinary tract infection due to vesicoureteric reflux explains the presence of pus cells on urinanalysis. - Hypeension is common in chronic interstitial nephritis. - Proteinuria in chronic intersititial disease is mild < 1.5/day. Post infective ,elomeru lo n ep h ri t is Absence of hematuria and presence mild proteinuria rules out post infective glomerulonephritis. Hetnaturia is universal in patients with post infective glomeru- lonephritis. It is always accompanied by significant proteinuria. Accelarated hypeension with acute renal failure Accelarated hypeension with acute renal failure cannot explain the presence of pus cells on urinanalysis. Idiopathic RPGN Idiopathic RPGN also does not explain the presence of pus cells on urinanalysis. [/INST] question: 8 yr old child with BP 180/100 minhg, urea 90, creatinine 5.3, urinalysis shows 15-20 pus cells, 12 RBC, protein 1+ & has no significant past h/o of similar complaint. Most likely diagnosis isaEUR' | options: A: Post infective glomerulonephritis B: Accelerated hypeension with ARF C: Idiopathic RPGN D: Chronic interstitial nephritis with VUR | answer: D </s> |
<s>[INST] context: Indoor air pollution can lead to chronic lung disease, adverse pregnancy outcome and pneumonia in child.Indoor Air PollutionThe commonest pollutant is tobacco smoke, but additional offenders are CO, nitrogen dioxide, and asbestos. Volatile substances containing polycyclic aromatic hydrocarbons generated by cooking oils and coal burning are impoant indoor pollutants in some regions of China.Wood smoke, containing various oxides of nitrogen and carbon paiculates, may not only be an irritant but also predisposes to lung infections and may contain the far more dangerous carcinogenic polycyclic hydrocarbons. Bioaerosols range from microbiologic agents capable of causing infectious diseases such as Legionnaires' disease, viral pneumonia, and the common cold, to less threatening but nonetheless distressing allergens derived from pet dander, dust mites, and fungi and molds responsible for rhinitis, eye irritation, and asthma.Radon, a radioactive gas derived from uranium widely present in soil and in homes, can cause lung cancer in uranium miners.Exposure to formaldehyde causes breathing difficulties and a burning sensation in the eyes and throat, and can trigger asthma attacks. [/INST] question: Indoor air pollution does not lead to: | options: A: Chronic lung disease B: Impaired neurological development C: Adverse pregnancy outcome D: Pneumonia in child | answer: B </s> |
<s>[INST] context: Reading is very important to help you learn English. To learn as much as you can from reading, you need to read different kinds of English. This book provides not only different kinds of English but also a good way to check your reading ability.
There are four parts in the book :
Part 1 is Messages : In this part somebody wants to send information in writing to somebody else. There is a test on timetables and a test on text messages .
Part 2 is People : In this part all the tests are about people . For example, there is an informal letter between friends . There is formal English in biography . There is a job application as a model to help with your writing, as well as testing your reading .
Part 3 is Places : In this part , too many different kinds of English are shown , some informal and some formal . There is the informal English of a holiday postcard . There is also the formal English in a letter of complaint .
Part 4 is Things : You will find some descriptive writing in this part . There are descriptions of clothes and of a computer .
You can do these tests in any order you like , or you can do all the tests with a formal or informal text .
I enjoyed writing this book and I hope you enjoy using it . [/INST] question: We can find the introduction to a product in _ . | options: A: Part 1 B: Part 2 C: Part 3 D: Part 4 | answer: D </s> |
<s>[INST] context: Be careful on April 1st! When your classmates say "Your shoes untied !", it may not be true. And if you find your alarm clock is set back an hour, this may be a joke too.
April Fool's Day is a traditional festival. On that day people play harmless jokes on others and then shout, "April Fool!" It's a "for-fun-only" day, so people don't buy gifts or get the day off work or school.
April Fool's Day started in France in the 16th century . At that time, New Year's Day was between March 25th and April 1st. When New Year's Day changed to January 1st in the mid-1560s, some people still celebrate it on April 1st. Others played jokes on them and called them "April Fools".
Each country celebrates April Fool's Day differently. In France, it is called "April Fish". The Frenchmen fool their friends by sticking paper fish to their friends' backs. When someone finds out this joke, they shout, "April Fish!" In England, it is bad luck to play an April Fool's joke on someone in the afternoon. Americans play small tricks on friends and strangers alike. [/INST] question: April Fool's Day started in _ in the sixteenth century. | options: A: the USA B: England C: China D: France | answer: D </s> |
<s>[INST] context: Nephrin The glomerular capillary wall is a filtering membrane and consists of the following structures i) Endothelial cells ii) Glomerular basement membrane iii) Visceral epithelial cells (podocytes) iv) Mesangial cells The visceral epithelial cell known as podocyte is impoant for the maintenance of glomerular harrier function. They are structurally complex cells that possess interdigitating foot processes (pedicels). The adjacent foot processes are separated by 20-30 nm wide filtration slits. The filtration slit or slit diaphragm maintains glomerular barrier function. They present a size selective distal diffusion harrier to the filtration of proteins and it is the cell type that is largely responsible for the synthesis of GBM components. Proteins located in the slit diaphragm control glomerular permeability. Impoant proteins have been identified in this regard Nephrin - Podocin - CD2 associated protein and - Actin cytoskeleton The impoance of these proteins in maintaining glomerular permeability is demonstrated by the observation that mutations in the gene encoding them give rise to nephrotic syndrome sclerosis . The mutations in these genes commonly lead to focal segmental glomerulosilerosis. Gene Chromosome in Prote encoded Disease NPHS1 19q13 Nephrin Congenitial nephritic syndrome of the finnish type NPHS2 lq 25-31 Podocin Steroid resistant nephritic syndrome 30% cases Mutations in the podocyte action-binding protein a actinin 4 also produce FSGS 96. [/INST] question: Finnish of nephrotic syndrome is caused by defect in following protein aEUR' | options: A: Nephrin B: Podocin C: Alpha actinin D: CD2 activated protein | answer: A </s> |
<s>[INST] context: STEPS IN WOUND HEALING Within 24 hours, neutrophils are seen at the incision margin, migrating toward the fibrin clot (neutrophilic infiltration + blood clot) Within 24 to 48 hours, epithelial cells from both edges have begun to migrate and proliferate along with the dermis and form a continuous thin epithelial layer. day 3, neutrophils have been largely replaced by macrophages, and granulation tissue progressively invades the incision space, Collagen fibres are now evident at the incision margins but do not bridge the incision day 5, neovascularization reaches its peak as granulation tissue fills the incisional space, collagen fibrils bridge the incision, full epithelial thickness with surface keratinisation second week, there is continued collagen accumulation and fibroblast proliferation end of the first month, the scar consists of a cellular connective tissue, largely devoid of inflammatory cells, replacement of collagen type 3 with collagen type 1 ref:-basic pathology, robbins 9thed, page 71 [/INST] question: Maximum collagen in wound healing is seen at- | options: A: End of first week B: End of second week C: End of third week D: End of 2 months | answer: B </s> |
<s>[INST] context: "It's So Good" in French, was one of Eartha Mae Kitt's first hit songs. But her childhood wasn't so good. She was born into a poor family in South Carolina in nineteen twenty-seven. When Eartha was eight, her mother remarried. Her stepfather did not like her so she was sent to New York City to live with an aunt, who helped pay for her piano and dance lessons.
Eartha Kitt worked in a factory as a young teenager. But she kept up her dance lessons. One day she tried out for a famous African-American dance company. Soon, Eartha was performing in shows around the world with the Katherine Dunham Dance Troupe.
In Paris, Eartha left the dance company to sing in a nightclub. Her voice was very attracting. She learned French quickly and gained French fans. Soon the film director Orson Welles discovered Eartha Kitt singing in Paris. Welles asked her to play a lead part in a play he was directing. The play made her find her acting talent for the first time.
After that Eartha Kitt returned to New York and appeared in the Broadway show with "Monotonous", a song about a bored woman, and it became famous. She soon signed with a record company.
Then Eartha Kitt acted her first role in a film in nineteen fifty-seven in "Mark of the Hawk". Kitt was very careful about choosing her roles in films. She refused parts that were not respectful to black people. In nineteen sixty-seven, Eartha Kitt got the part of Catwoman on the popular television series "Batman". Fans loved the special way she said her "r"s to create a sound like a cat, which made her an unforgettable Catwoman.
She was strongly against the Vietnam War and in nineteen sixty-eight she became blacklisted in America. For about ten years, she could only find work in other countries. But that brought her a greater international achievement. [/INST] question: What did Eartha Kitt do when she first performed around the world? _ . | options: A: Sing B: Dance C: Direct D: Act | answer: B </s> |
<s>[INST] context: Gabriel Garcia Marquez ,who was awared the Nobel Prize for Literature in 1982,passed away at the age of 86 on April 17,2014. The world paused to remember the cultural giant .
Garcia Marquez was born in Colombia ,but he spent most of his adult life in Mexico City . As one of the most famous writers ,he was widely regarded as "a giant of 20th-century literature " . Garcia Marquez wrote in a style called "magical realism "In such works,people live a daily life in a certain period of time in history . But meanwhile ,magical things happen to them .
Garcia Marquez is best known for his 1967 novel ,One Hundred Years of Solitude ,which has sold about 50 million copies . It tells the tale of the small and _ town of Macondo which was separated from the outside world -of its founding and its troubled history over a hundred years . The story is a metaphor for the development of Colombia since the 19century . As Colombian President Juan Manuel Santons said , Garcia Marquez wrote about "the very essence of the Latin American beings " . [/INST] question: Garcia Marquez was born in the year _ . | options: A: 1914 B: 1928 C: 1967 D: 1982 | answer: B </s> |
<s>[INST] context: When a customer came into a Mexican restaurant in Georgia with an unusual request, a selfless waiter didn't hesitate to help him out.
A disabled man with no hands who ordered a meal at Cinco cle Mayo Mexican Grill in Douglasville on Sunday afternoon hoped someone might be able to help him eat his lunch.
Server Alex Ruiz, 22, was more than happy to help as he sat opposite from the man and helped him enjoy his meal.
The heartwarming moment was captured in a photo by one of Ruiz's workmates, Crystal Figueroa. She posted it on the restaurant's Facebook page.
"He's a great person," Figuero, 24, whose father manages the restaurant, said.
"He's always so nice, and the fact that he just came out of nowhere and helped a man he doesn't even know have a meal says everything. That just shows the person that he is.
One of Figueroa's friends, Reginald Widener, also witnessed the moment and posted the photo on his Facebook page.
"This seriously hit me right in the soul," Widener wrote.
The waiters did not get the name of the man. He had never eaten in the restaurant before, according to Figueroa. But Ruiz jumped at the chance to help.
"I just feel like people should see that there're still good people out there," Figueroa said. "It was just a happy moment." [/INST] question: Why did Alex Ruiz help the man eat his lunch? | options: A: The man was rich B: The man had no hands C: They knew each other D: He is Alex Ruiz's father | answer: B </s> |
<s>[INST] context: There are many ways for us to reduce waste. For example, we can reuse paper and plastic bags. We can also recycle newspapers, glass, and cans to make new things. Here are some useful ways to reduce waste.
* Write on both sides of paper. Many people write on only one side of their paper. Why not stop wasting the other side? Some students only use half the pages of their notebooks before getting new ones. Try to use up all the paper. People often give cards on birthdays or festivals. How about trying to send e-cards instead?
* Don't throw away your old batteries. Maybe you do not know that old batteries make the Earth dirty. This is because they have poisonous parts. So, don't throw away batteries. Keep them together. Try to use rechargeable batteries for your games and CD players.
* Donate all your unwanted clothes. There are many poor families in China. You may ask your mother to collect your unwanted clothes. Then you can pass them on to those poor children who do not have clothes to wear. You will feel happy that you are helping someone else. Also, you can ask if your friends or relatives want them before throwing them away. [/INST] question: What should we do on a friend's birthday? | options: A: Give cards B: Send e-cards C: Give nothing D: Write on the cards | answer: B </s> |
<s>[INST] context: Acyclovir and ganciclovir are variants of acycloguanosine and are used to treat herpes simplex virus and cytomegalovirus infections, respectively. Both agents are viricidal and act by interfering with viral polymerase activity. In the case of herpes simplex virus infection, the virally- coded thymidine kinase monophosphorylates the acyclovir. Cellular kinases then add two more phosphates, creating a nucleotide that is accepted by the virally-coded DNA polymerase. The structural analog is incorporated into the growing DNA chain and elongation is terminated. Ribavirin, used to treat paramyxovirus (respiratory syncytial virus) infection, works by interferring with viral messenger RNA (mRNA) capping. Amantadine, used to treat influenza A infections, blocks viral un coating. It is most effective when given before viral infection occurs. Reverse transcriptase inhibitors (e.g., azidothymidine, didioxycytocine, didioxyinosine) directly interfere with normal enzyme activity. These agents are virostatic, and virus growth occurs when the agents are removed. Interferons are induced as a result of viral infection of a cell. Products of viral nucleic acid replication activate genes that code for interferons, which directly prevent virus growth by inducing an antiviral protein within virus- infected cells. [/INST] question: How does acyclovir inhibit herpes virus replication? | options: A: They block capping of viral mRNA B: They inhibit reverse transcriptase activity C: They inhibit viral polymerase activity D: They block viral uncoating | answer: C </s> |
<s>[INST] context: At the end of every British summer I find myself praying for a proper winter, one that will allow a bit of fun: sledging, snowballing, snowman-building. I'm not very demanding; I don't need amazing downhill skiing and the Cresta Run. What I want is a few days out with the kids. And, much as I like blue skies and sun in summer, I'd exchange it every time for frozen ponds, a hillside covered in fresh snow and ice hanging off the houses. Maddy, 11, wants the same and so, instead of waiting and hoping, we are going to make sure. We are going to Sweden.
Winter fun in Sweden is a bit more advanced than in most of the UK. They do snowshoeing, ice-fishing, snow house-building and so on. They also do lots of Father Christmas matters, which Maddy didn't want: "I'm too old for that kind of nonsense, Dad." Above all, what Maddy wanted was dogs with puppies. She's not too old for that.
We flew to Lulea, a city at the top of the finger of Baltic Sea that reaches out to the north between Sweden and Finland, almost touching the Arctic Circle, then transferred, with some other winter-hungry families, to woodland houses by the sea. There was plenty of snow and ice, but the guides were keeping a nervous eye on the instrument for measuring temperature, which was dangerously close to zero.
"Normally, we are 10degC below," said Roger, our guide, who was also handing out our equipment for the days ahead: snowshoes, boots, gloves and so on. A holiday that provides all the necessary outfits will save you a fortune. [/INST] question: How did they go to the city of Lulea? | options: A: By sea B: By air C: By train D: By car | answer: B </s> |
<s>[INST] context: Hirschsprung's disease - is characterised by the absence of ganglionic cells in the distal colon and rectum - it occurs due to the failure of migration of neural crest cells to distal bowel segments - affects cells in both - myenteric and submucosal plexuses - functional obstruction developes in the affected pa. It can be anatomically divided into four types according to the length of the aganglionic segment: sho segment disease: ~75% rectal and distal sigmoid colonic involvement only long segment:~15% typically extends to splenic flexure/transverse colon total colonic aganglionosis:~7.5% (range 2-13%) also known as Zuezler-Wilson syndrome occasional extension of aganglionosis into the small bowel ultrasho segment disease 3-4 cm of internal anal spinchter only controversial entity - Definitive diagnosis :- by rectal biopsy Barium enema demonstrates cone shape transition zone and reversal of rectosigmoid ratio. Most impoant sign on barium enema is a sudden change of caliber from the narrow aganglionic segment and dilated proximal bowel [/INST] question: Definitive diagnosis of Hirschsprung's disease is done by? | options: A: Rectal Manometry B: Barium enema C: Rectal Biopsy D: Enteroclysis | answer: C </s> |
<s>[INST] context: Types of Tympanoplasty Wullstein classified tympanoplasty into five types . Type I Defect is perforation of tympanic membrane which is repaired with a graft. It is also called myringoplasty. Type II Defect is perforation of tympanic membrane with erosion of malleus. Graft is placed on the incus or remnant of malleus. Type III Malleus and incus are absent. Graft is placed directly on the stapes head. It is also called Myringostapediopexy or Columella tympanoplasty. Type IV Only the footplate of stapes is present. It is exposed to the external ear, and graft is placed between the oval and round windows. A narrow middle ear (cavum minor) is thus created to have an air pocket around the round window. A mucosa-lined space extends from the eustachian tube to the round window. Sound waves in this case act directly on the footplate while the round window has been shielded. Type V Stapes footplate is fixed but round window is functioning. In such cases, another window is created on horizontal semicircular canal and covered with a graft. Also called fenestration operation. Re: Textbook of Ear, Nose and Throat, Dhingra, 6th Edition [/INST] question: Columellar tympanoplasty is | options: A: Type I B: Type II C: Type III D: Type IV | answer: C </s> |
<s>[INST] context: The two things - snow and mountains - which are needed for a ski area are the two things that cause avalanches, large mass of snow and ice crushing down the side of a mountain--often called "White Death."
It was the threat of the avalanche and its record as a killer of man in the western mountains that created the snow ranger. He first started on avalanche control work in the winter of 1937 -38 at Alta, Utah, in Wasatch National Forest.
This mountain valley was becoming well known to skiers. It was dangerous. In fact, more than 120 persons had lost their lives in 1936 and another 200 died in 1937 as a result of avalanches before it became a major ski area. Thus, development of Alta and other major ski resorts in the west was dependent upon controlling the avalanche. The Forest Service set out to do it, and did, with its corps of snow rangers. It takes many things to make a snow ranger. The snow ranger must be in excellent physical condition. He must be a good skier and a skilled mountain climber He should have at least a high school education, and the more college courses in geology, physics, and related fields he has, the better.
He studies snow, terrain, wind, and weather. He learns the conditions that produce avalanches. He learns to forecast avalanches and to bring them roaring on down the mountainsides to reduce their killing strength. . The snow ranger learns to do this by using artillery, by blasting with TNT, and by the difficult and skillful art of skiing avalanches down.
The snow ranger, dressed in a green parka which has a bright yellow shoulder patch, means safety for people on ski slopes. He pulls the trigger on a 75 mm. Recoilless rifle, skis waist deep in powder testing snow stability, or talks with the ski area's operator as he goes about his work to protect the public from the hazards of deep snow on steep mountain slopes. [/INST] question: The snow rangers are employees of _ | options: A: the Forest Service B: the Resource Bureau C: the Tourist Board D: the Sports Bureau | answer: A </s> |
<s>[INST] context: Disasters happen all the time somewhere in the world. Are you ready if one hits your neighborhood next week? Find out what you need to do now before it is too late. Let's take an earthquake for example.
During an earthquake, get under a strong object like the kitchen table. Don't leave the building during the shaking, or you might be hurt by falling objects from the outside of the building.
When you are in bed during the night and an earthquake happens,simply roll off the bed. There will be a safe void around the bed.
If you are watching TV and you cannot easily run away by getting out through the door or window, then lie down and curl up next to a sofa, or a large chair.
Never go to the stairs. The stairs are likely part of the building to be broken. Even if the stairs are not destroyed by the earthquake,they may fall down later when people run down.
Try to get into an open area away from trees,buildings,walls,advertisement boards and power lines if you are outdoors.
If you are driving when an earthquake suddenly happens,just stay in your car until the shaking ends. However, if the footbridge falls and breaks your car,get out of it and sit or lie next to it. All the broken cars have voids 3 feet high next to it. [/INST] question: What should you do if you are in a building when an earthquake happens? | options: A: Rush out quickly B: Sit in the kitchen C: Stay below strong objects D: Go down the stairs | answer: C </s> |
<s>[INST] context: What might the future be like? Here are some predictions: things to come, things to go.
The Spring Festival, the most important Chinese holiday when everyone returns home, has caused headaches for millions of Chinese. More than 2 billion people travel at the same time, making getting travel tickets and the journey difficult. But in 28 years, Spring Festival travel may not be a problem at all. China plans to build more than 120,000 kilometers of railway and a fast transportation network that will serve 90% of the population by 2020. And because most of China will be cities, people will not have to go to other places to find a job, so it will no longer be a problem.
Newspaper will come to an end in 2043. In the future, digital newspapers will be sent to personal web tools through Internet. Readers can discuss topics with journalists and editors. Information will move faster.
Oil is running out faster than expected. But scientists have found something else for oil as fuel. Coal, natural gas, solar power, nuclear power and even water can take the place of oil as sources of energy.
Schools will go electronic. Computers will be important and popular among the students. Everything will be in the computer and students will not need to bring books to school. They will find information on the Internet. A computer will be the students' library, schoolbag and connection to the outside world. There will be robot teachers. They will check homework on computers and communicate with the students' parents through e-mail. And school buses will be like spaceships, comfortable and safe. [/INST] question: More than 2 billion people have a hard time returning home during _ . | options: A: Christmas Day B: National Day C: the Spring Festival D: the mid-autumn Festival | answer: C </s> |
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