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<s>[INST] context: When he was a boy, Tim was much influenced by the books about the sea, but in fact by the age of fifteen he had decided to become a doctor rather than a sailor. His father was a dentist and as a result, Tim had the opportunity of meeting many doctors either at home or elsewhere. When he was fourteen he was already hanging around the clinic of a local doctor where he was supposed to help to wrap up medicine bottles, but was actually trying to listen to the conversations taking place between the doctor and his patients in the next room.
During the war Tim served in the Navy as a surgeon . "That was the happiest time of my life. I was dealing with very real suffering and on the whole making a success of it." In California he taught the country people simple facts about medicine. He saw himself as a life-saver. He had proved his skills to himself and his ability to take decisions. Thus, while he was able to tell them what to do, he could feel he was saving them. After the war, he got married and chose to be a doctor in the countryside, working under an old doctor who was popular in the area, but who hated the sight of blood and believed that the secret of medicine was faith. This gave the young man many opportunities to go on working as a life-saver. [/INST] question: Tim decided to be a doctor when he was _ . | options: A: fourteen B: fifteen C: serving in the Navy D: working in clinic | answer: B </s> |
<s>[INST] context: Giant pandas are now extremely rare. Their number is less than 1,000 in the wild. The hunting of pandas has been banned for many years, so this is not the problem. Destruction of its habitat, when areas are cleared for growing crops, is one of the main reasons for panda's decline . Another reason is that the bamboo on which they mainly feed, is dying back. The pandas find it difficult to move to new feeding areas. As the bamboo disappears, the pandas simply starve to death.
Bamboo is a poor source of food, and pandas have to eat up 45kg of it every day, a process that takes them up to 16 hours. The process goes on day and night, with the pandas in a constant cycle of eating for eight hours and sleeping for four. They can eat other foods, but will rather starve than change their diet when bamboo is scarce.
Giant pandas are very good climbers, and use this skill to escape from the enemy. The giant panda lives alone for most of its life, only coming together with another of its species for long enough to mate. A newborn panda baby is born hairless and blind, is about 15cm long and weighs only 100g. The baby will stay with its mother for about 18 months, until it is able to set up its own territory
Chinese and American scientists are studying giant pandas and their habits in order to put in place a major conservation programme. Zoos around the world are taking part in panda breeding programmes. There is still hope that with human's help, the giant panda can survive in the wild. [/INST] question: How much bamboo does a panda eat every year? | options: A: Nearly 3 tons B: Nearly 2 tons C: Almost 1 ton D: A half ton | answer: B </s> |
<s>[INST] context: "Most common neuroendocrine tumour associated with MEN I is Gastrinoma."
MEN -1 is also called werner syndrome.
It is characterized by abnormalities involving the
- Parathyroid
- Pancreas
- And Pituitary gland thus the mnemonic device the "3 Ps".
Parathyroid
Primary hyperparathyroidism is the most common manifestation of MEN I (80% to 90%) of patients.
It is the initial manifestation of the disorder in most patients appearing in almost all patients by the age of 40 to 50.
Parathyroid abnormality includes both adenoma and hyperplasia.
Hypercalcemia occurs due to hyperparathyroidism.
Pancreas
Pancreatic islet cell tumours are the 2nd most common abnormalities in MEN I syndrome.
Gastrinoma is the most common enteropancreatic tumour observed in MEN I.
Insulinoma are second most common enteropancreation tumour in MEN I.
Pituitary
Most frequent anterior pituitary tumour encountered in MEN I is prolactinoma.
Also remember these important facts about MEN I syndrome -
MEN I syndrome is caused by germ line mutations in MEN I gene at 11q13.
MEN I is a classic tumour suppressor gene.
The dominant clinical manifestations of MENI are due to peptide hormones overproduction such as Zollinger Ellison syndrome due to gastrinoma and recurrent hypoglycemia. Hypercalcemia can result due to hyperparathyroidism. [/INST] question: Which of the following endocrine tumors is most commonly seen in MEN I? | options: A: Insulinoma B: Gastrinoma C: Glucagonoma D: Somatostatinoma | answer: B </s> |
<s>[INST] context: What is the hottest topic at your school recently? In Taiyuan No.55 Middle School, it's money.
The school held an activity called "making money" last weekend. About 200 Junior 1 and Junior 2 students were divided into 30 teams. They went out to make money by selling things.
What did they choose to sell? Some sold newspapers; some chose bottled water; some sold environmentally friendly shopping bags and bamboo baskets.
Hu Qing's team decided to sell some useful books in front of the Children Activity Center. They thought parents would like to buy the books for their children. But unfortunately, they met urban management officers . The officers asked them to leave. "We played hide-and-seek with the officers for the whole morning" said Hu. "Finally we had to give up."
Wang Bing and her team sold ice cream in a square. They didn't meet any officers. But few people were interested in what they were selling. The team then put up a board saying "For Country Kids". It worked. More people came to their stall . A foreigner even gave them 100 yuan. "He didn't want any change. He said he wanted to help the children," said Wang. "We were touched." Later that day they gave the 100 yuan and more to the "Project Hope" office.
Meng Zhaoxiang and his team were luckier. They sold all their cakes in four hours, spending 39.5 yuan and getting back 80 yuan. They made 40.5 yuan. "It was not easy to make the money," said Meng. "Some people just looked. Others just tasted but didn't buy. Now I know how hard it is for our parents to make the money we need to lead happy lives." [/INST] question: . In Taiyuan No.55 Middle School, what the students talk more about is _ . | options: A: the officers B: money C: the activity called "making money D: the money they made last weekend | answer: B </s> |
<s>[INST] context: MSF stands for Medicines Sans Frontiers. It's also known as Doctors Without Borders . Medicines Sans Frontiers is French. This organization was set up by some French doctors in 1971. Since then, MSF has sent trained doctors all over the world to help people who have suffered from disasters, such as wars and illness.
Now, about 3,000 doctors and nurses work for MSF. And over 27,000 doctors have volunteered for MSF so far. The organization received the Nobel Peace Prize in 1999. All kinds of doctors can volunteer for MSF. They need to be ready to go almost anywhere in the world and, of course, they should face difficulties. Most of MSF's work is in Africa. When MSF chooses doctors for a task, they have to go for at least six months. When doctors have completed a few tasks and become experienced, they might be sent on an emergency task following a disaster, such as an earthquake.
But why would doctors leave a comfortable life and a good pay to join MSF? Some of them say the experience they have is a great help in their life. And they say that it's great to give others a helping hand.
MSF needs support. They get donations from the government and businesses. But 80% of its donations come from doctors themselves. [/INST] question: MSF is a famous _ . | options: A: government B: charity C: business D: training centre | answer: B </s> |
<s>[INST] context: A new camera made by a company named Netatmo has facial recognition software that can tell parents at work that their children have returned from school, or that a package has been taken to their home. It can also tell them if a stranger has entered their home.
Janina Mattausch is a product marketing manager for Netatmo.
"The common security cameras at present are not that smart. So, they can tell you if something is moving but they don't necessarily know if it's a human being or, ah, if it's your kids --they don't know the difference, so they will warn you all the time. "
When family members enter a home, the new camera "recognizes" ( ) them and sends information to the owner's smartphone. The owner can choose to see the video then or latcr. But if an unknown person enters a home, the camera will send the owner a warning that will cause an alarm to sound on the owner's smartphone.
That is what happened recently to a smart home camera owncr named Darrmen. He lives in Paris.
"On a Friday I was at work,atending a big monthly meeting when my phone warned. At first I told myself 'Oh, it must be a mistake, maybe I have to set the systcm again. ' -but the notice on my phone was telling me that there was a movement in my flat and also a face that the software did not recognize. "
He watched the video and was very surprised by what he saw.
"I saw a person I did not know with his shoes on. I was watching it live on vidco. So I felt totaly unbelievable, frozen. I asked a workmate to take me back home as fast as possible and I callcd the police on the way. "
With the help of the video, the police found the intruder later that day. [/INST] question: The new camera made by Netatmo can _ . | options: A: warn the strangers B: recognize the comers C: stop the visitors D: welcome the children | answer: B </s> |
<s>[INST] context: Jason
What I like best is seeing Arsenal win and playing football. If I am feeling sad I will play a football game on my Play Station 2. The best day I have ever had was when I finished first in the 800-metre race at my secondary school. It was a school record, although I didn't know that at the time. My family makes me happy, too.
Antonio
My little sister makes me sad because she always tells tales on me to my mum. If I am having a bad day, food cheers me up. I like chili con carne and sweet chili crisps. It makes me happy because I want to be big and have lots of energy.
Usman
I haven't done anything very exciting in my life but one of my best achievements is that I got a good report from my school this year, because last year I got a bad one. People on TV make me laugh, particularly Eddie Murphy. If I am having a bad day I watch Basil Brush. I am good at making other people happy. I just talk and my friends start laughing -- they think I am silly.
Ashleigh
If I'm having a bad day, knowing that someone is there for me can make me happy. I wouldn't say I'm the best at making other people happy, but I know that just being a good friend to other people is important. The things I like doing are singing, dancing, hanging out with my friends and just being lively and funny.
Kinzey
The most exciting thing I have ever done in my life was when I went abseiling in Wales. But that was a one-off. The things I do all the time are playing football, watching movies and going places with my friends. I know it sounds bad, but what I find funny is when people hurt themselves. If I am having a bad day and I see someone having a worse day than me, that makes me feel better. [/INST] question: Food is very important for _ when he has a bad day. | options: A: Kinzey B: Ashleigh C: Antonio D: Usman | answer: C </s> |
<s>[INST] context: Cyprus is the third largest island and one of the most popular tourist destinations in the Mediterranean Sea. It attracts over 24 million tourists every year. It gained independence from the UK in 1960. Cyprus is a developed country and has been a member of the European Union since 1 May ,2004. It didn't begin to use the euro until 1 January. 2008.
As a tourist destination, Cyprus has clean beaches and fine weather all the year round. There are Roman and Greek ruins on the island, which attract tourists most.
You can enjoy skiing and hiking in its huge mountains and charming villages. In the
towns and cities, there are some modern hotels, bars and clubs with bright lights and rich nightlife. The story of the island can date back over 10,000 years. Cyprus has long been seen as an important strategic base. Many civilizations have swept through it over the years. In 1974 the Turkish army arrived on the northern coast of Cyprus. They were invited by the Turkish Cypriot leader in order to protect the Turkish villages. Since then the Turkish army took control of the northern third of the island. The Greek Cypriot controlled the other. UN peacekeeping forces kept the peace between the two sides.
Although it has political problems, Cyprus is a country that easily links modern
European culture with its past. Here, visitors can discover clean beaches, all kinds of
grape wine and ancient ruins. With fruit trees around, the old stone villages make
tourists feel that modern Europe seems a very long way away indeed. [/INST] question: What's the most attractive to tourists in Cyprus? | options: A: Its fine weather B: The modern culture C: The color1ful nightlife D: The ancient ruins | answer: D </s> |
<s>[INST] context: Which day is the most important for you? Your birthday, the first day of your work or the day you win a prize. Many teenagers may think their birthday is the happiest time because they can receive many wonderful presents and have much fun with their friends. Others may regard the starting day of their work as the most meaningful. They think it's the first big step in their life and they can depend on themselves. They like to deal with challenges rather than to ask for the help of adults.
According to a survey, more than half of the Chinese people, certain ages and birthdays are especially important. One hundred days after a baby's birth has special meaning. On that day, relatives and friends come to bless the baby. In northern part of China, like Inner Mongolia, a child's 12th birthday is a big day. This is when a child becomes a teenager. Eighteen is another important age, which means you must be responsible for what you have done in laws. As for adults, maybe the anniversary of their marriage is the most important. For some old people, the 60th or 70th birthday is also very important. They like to be cared about by all his family and friends, and the big family get-together can provide them a good chance to recall the past. [/INST] question: Which is not regarded as the most important day for teenagers? | options: A: their first day of work B: the day they win C: their birthday days D: the anniversary of marriage | answer: D </s> |
<s>[INST] context: (Lichen scrofulosorum) (202-Behl lCfh, 1756-Dorland 28th, 219- Neena khanna)TUBERCULIDES - Group of disease where the evidence for a tuberculous etiology is not definite {May be hypersensitivity reaction) but which show a tuberculous granuloma on histology and respond to ATT)Conditions included in TuberculidsCutaneous Tuberculosis (Non Tuberculides)* Lichen scrofulosorum* Lupus vulgaris* Erythema- induratum* Sacrofuloderma* Papulonecrotc tuberculides (Acne-scrafulosorum)* Tubercularis cutis verrucosus* Lupus miliaris disseminatus faciei* Miliary tuberculosis and metastatic tuberculosis* Rosaceous tuberculide* Miliary tuberculosis and metastatic tuberculosis abscess may also present as cutaneous tuberculosis(According to 'Behl' Erythema - nodosum is also a tuberculide while some texts do not include it as a tuberculide)Features of TB in AIDS patients* |Sputum positivity *** Little or no cavitation*** |ed extra pulmonary tuberculosis *** Negative PPD skin test*** Lack of classic granuloma* Atypical CXR- Diffuse interstitial or military infiltrate* Response to short course chemotherapy is similar*** but adverse effects may be more pronounced including severe or even fatal skin disease* High rate of reactivation Indications of pulmonary resection in tuberculosis / haemoptysis areAbsoluteRelative* Massive haemoptysis (600cc/24 hours)* Destroyed lung, positive sputum* Bronchopleural fistula* Suspicion of carcinoma* Haemoptysis* Bronchial stenosis* Persistent positive sputum* Open negative cavity* T.B. Empyema* Atypical tuberculus infections* Aspergilloma (Fungus balls)Lupus - vulgaris - is a form of cutaneous tuberculosis that is seen in previously infected and sensitized individualsLupus- pernio - is a particular type of sarcoidosis that involves the tip of nose & earlobes with lesions that are violaceous in colourSpino- ventosa - Tuberculosis of bone in which bone is expanded & the cortex thins eg digitsScrofuloderma - Tuberculosis first develops in a lymph node or a bone producing a swelling and subsequently ruptures through the overlying skinFalse negative tuberculin skin test - reactions may result from improper testing technique - concurrent infections, malnutrition advanced age, immunologic disorders, lymphoreticular malignancies, corticosteroid therapy, CRF, HIV infections and fulminant tuberculosis [/INST] question: Tuberculides are seen in | options: A: Lupus vulgaris B: Scrofuloderma C: Lichen scrofulosorum D: Erythema nodosum | answer: C </s> |
<s>[INST] context: Astronaut Mark Kelly announced today that he is retiring from NASA in order to focus on the recovery of his wife, Gabrielle Giffords.
Kelly, who is 47, began his NASA career in 1996. He has traveled to the International Space Station four times and served aboard space shuttles Endeavour and Discovery. Most recently he was commander of Endeavour's final voyage, which ended on June l.
"After 25 years of service to our country, I am retiring from the United States Navy and leaving NASA. My retirement will take effect on October l. " he said.
"This was no easy decision. Words cannot express my deep gratitude for the opportunities I have been given to serve our great nation. And I have always been proud to be a member of the NASA. Public service has been more than a job for me and for my family. My brother continues to serve in NASA and in the Navy. My parents are retired police officers. And my wife Gabrielle proudly serves in the US House of Representatives." he continued.
"As life takes unexpected turns we frequently come to a crossroads. I am at this point today. Gabrielle is working hard every day on her way to recovery. I want to be by her side. Stepping aside from my work in the Navy and at NASA will allow me to be with her and with my two daughters. I love them all very much and there is no doubt that we will move forward together. After some time off, I will look for new opportunities and I'm hopeful that one day I will again serve our country." Kelly said.
On Jan 8, Giffords was shot in the head and was severely injured while meeting with her supporters. She returned to her Tucson home last week for the first time since then. [/INST] question: Mark Kelly must have been_when he announced his decision. | options: A: regretful B: cheerful C: peaceful D: meaningful | answer: A </s> |
<s>[INST] context: What could be cuter than your puppy giving his doggy friend a kiss on the nose? Nothing, really. But is your dog actual-fly planting a kiss on his friend? Yes, but that's only one of the reasons your dog may lick another dog's nose. Here are some other reasons why your dog may lick another dog's nose.
During an introduction, a shy and lower-ranking dog will lower his head, avoid direct eye contact and gently extend his tongue to lick the nose of a more confident and high-ranking dog. The first dog licks the nose of the second dog to simply make it know that:he comes in peace.
Dogs who are already friends will also trade kisses. Two strongly bonded dog pals will lick and clean each other. They give each other "dog kisses" showing friendship.
Puppies also "kiss" their mothers, but it's not a gesture of love. When puppies stop suckling their mothers' tits for milk and start to eat semisolid food instead;they lick their mothers' mouths and noses in the hope of getting the mother to regurgitate some semi-digested food.
So how to help your _ dog make friends with other dogs? You can carefully select confident-but-friendly and good-tempered dogs to play with your shy dog, to help him develop his social skills. Also consider taking him to a special training class that focuses on socialization and positive training technique.
Do not disturb them when your two dogs play "kiss" briefly with each other. Sit back and enjoy this display of friendship. Then call them over and have them do a command such as "sit'' or "shake paws". Offer them treats as a reward for being good to each other.
If you foster a dog and have three or more resident dogs, introduce the foster dog to your brood dog one at a time and let muzzle licking between them happen naturally. Start with your least reactive or most friendly dog. Never force an in production between the dogs because this can deepen the foster dog's submissiveness or spark a fight. [/INST] question: We know a shy and lower--ranking dog licks the nose of a higher-ranking dog to _ . | options: A: ask the dog for help B: show he is friendly C: show his anger D: show his respect for him | answer: B </s> |
<s>[INST] context: How do you feel when you stay in hospital alone? Jenny, 13, a US student, feels bored. She knows the feeling because she has been in hospital many times herself. One day, she thought of an idea--if patients could get some books to read, they would feel better. So, from May, she and many of her friends began to collect books for hospital patients.
In six months the students collected 1,250 books at school. They decided to donate the books to the North Shore Medical Centre, a children's hospital next door to their school. "There are books for kids of all ages, from babies up to high school level." said Jenny.
The students put the books into "early readers", "middle readers" and "advanced readers". Then they wrote their best wishes to patients on bookmarks and letters, put the books in big boxes and donated them to the hospital.
"We wrote things like, "Keep on reading!' and 'Hope you feel better!," said John, 14, Jenny's brother. "And we also wrote some funny things to make them laugh."
Frank, 12, and Steven, 14, helped carry 16 large boxes of books into a car. "I think these books will make me a lot of patients feel happy." said Frank. Steven shared his opinion. "It is really the most meaningful thing that I have ever done in my life." [/INST] question: Who first thought of the idea of helping those bored patients in hospital? | options: A: John B: Frank C: Steven D: Jenny | answer: D </s> |
<s>[INST] context: As most people know, in the past few years, sandstorms have swept across many cities and areas of North China, polluting the air and disturbing daily lives of human beings. People look dirty and suffer many kinds of illnesses, such as breath difficulty. The sandstorm is such a serious problem that it has not only _ the industrial and agricultural development of our country but also caused a lot of trouble to the living conditions of the Chinese people. It is expected that effective measures should be taken as soon as possible through our joint efforts to limit its occurrence.
So what should we do with the frightening sandstorms? Some experts put forward practical suggestions as follows: For one thing, more funs ought to be put into tree planting and forest protection so as to keep more water resources within the surface of the earth. For another, governments of all countries should make laws on environmental protection.For example, banning the use of throw-away chopsticks and punishing illegal tree cutting. Scientists should also study and find ways to cut down the degree of its destruction and to improve the whole environment.
How people look forward to sunny days with little breeze touching their faces now and forever! Nevertheless, I am fully confident that the golden days can come back so long as everyone tried his best to protect natural environment from today on. [/INST] question: How many ways do some experts put forward to fight against sandstorm? | options: A: 5 B: 4 C: 3 D: 2 | answer: C </s> |
<s>[INST] context: THURSDAY, July 9 (Health Day News) -- A new study that found that a lower calorie diet slowed the aging process in monkeys could be the best proof yet that restricted diets might do the same for humans.
"The big question in aging research is, 'Will caloric restriction in species closely related to humans slow aging?'" said Richard Weindruch, senior author of a paper appearing in the July 10 issue of Science. This is the first clear demonstration that, in a primate species, we' re inducing a slowdown of the aging process -- showing increased survival, resistance to disease, less brain atrophy and less muscle loss.
"This predicts humans would respond similarly," added Weindruch, professor of medicine at the University of Wisconsin and an investigator at the Veterans Hospital in Madison. Another expert noted that, despite some highly publicized studies in certain species, the link between restricted eating and longer lifespan has been far from proven.
"The idea that dietary restriction extends lifespan in all species is not true. Many strains of rats and mice do not respond. In some strains, it' s actually deleterious," explained Felipe Sierra, director of the biology of aging program at the US National Institute on Aging (NIA), which supported the new study. "The fact that it doesn't work in some mice but it does seem to work in monkeys is surprising and it gives us hope."
But there's a larger question: how to change humans' increasingly careless eating habits. "This finding doesn't give me hope that humans are going to go into dietary restriction," added Marianne Grant, a registered dietitian at Texas A&M Health Science Center Coastal Bend Health Education Center in Corpus Christi. [/INST] question: Which of the following statements about Weindruch is true? | options: A: Adequate sleep is another way to reduce the speed of aging process B: This experiment indicates restricted diets could extend humans' lifespan C: The experiment was a failure in some species such as mice D: The experiment which had been tested on humans got a great success | answer: B </s> |
<s>[INST] context: Finding a suitable place to live is not easy for a student who first arrived in a strange place . I was lucky because I had booked a dormitory with the school before I arrived .. I t was a flat with seven independent rooms and a shared bathroom and kitchen . all of my flatmates are all students form Britain . I thought I was lucky to be part of this flat with these energetic young men . However , I found myself unhappy with them only a few days after I stayed there . These young people seemed never to be quiet . Usually they would not come back until late into the night .They even played football in the room whenever they like , whether _ was early morning or late night . Worse still , they always had parties . Those loud music and laughter made me sleepless the whole night . Finally , I had no choice but to ask the authority to move me to another flat where most of the students were international students pursuing their master degrees . They were older in age and hold heavier study burden . So they were quieter .
My advice for those who want to study in the UK is to get in touch with the international student accommodation service of your school first and tell them to arrange for you to share a flat with graduates before you come here. [/INST] question: What was the trouble while living with the British students? | options: A: They loved football too much B: They often held parties C: They disturbed the writer's living greatly D: They went to bed too late and got up too early | answer: C </s> |
<s>[INST] context: If you want to find out a piece of information about anything , the best place to search for it is Wikepedia. This online encyclopedia is written by thousands of people around the world. Anyone can add or change the information if he or she finds it not correct or not well written. In this way, people who know a lot about a certain subject can write about it even if they are not university professors.
What is more, Wikepedia includes articles written in about 235 languages. This fact makes it one of the few websites on the Internet that are truly international. It was started in 2001 by Larry Sanger and Jimmy Wales, as a free online English-language encyclopedia project. By April 2008, over 10 million articles had been put on Wikipedia. A quarter of the articles are in English. Wikipedia is also a place where people can find the latest news.
However, Wikipedia has its own problems. There have been many complaints that some of the information on Wikipedia is not accurate and some important subjects are not included. This has led to arguments between the writers of articles. The people running Wikipedia say that the accuracy of the information is improving and that it is one of the top 20 visited websites on the Internet.
So, if you are looking for some information, why not try Wikipedia? [/INST] question: Wikipedia is _ . | options: A: a computer game B: a name of a magazine C: a free university D: an online encyclopedia | answer: D </s> |
<s>[INST] context: Her opponent was the defending champion whose childhood dream was to win the French Open. She was the underdog who never saw the tournament on TV as a girl in China and never thought she'd get far on the red clay of the French Open, one of the four tennis Grand Slams .
But it was Li Na who fell on her back in triumph on June 4. Nearly two hours' hitting gave Li a 2-0 victory over Francesca Schiavone of Italy and made her the only tennis player, man or woman, from Asia to take home a Grand Slam title.
Chinese media have been swept along by the praise. An editorial carried by Xinhua News Agency said "Li Na is the best PR (Public Relations) for China," and called her an "outstanding name card for the country" and a "brilliant diplomat". It compared Li to Chinese NBA star Yao Ming, noting that both "can speak very fluent English, and both of them have a kind of sense of humor that is appreciated by foreigners".
Success has come late for Li. She once gave up tennis for two years and studied journalism at Wuhan's Huazhong University of Science and Technology. But in 2004, she returned and continues to play the best tennis she could.
"Dream comes true," Li said after the match. "I am so happy that my efforts have paid off." Li has often been seen as a rebel , or at least a representative of a new generation. She has a tattoo , has dyed her hair many different color1s and has even been known to yell at her husband in public. "The plain-speaking, tattooed, individualist has the ability to transcendthe sport and become a global star", the BBC news reported.
No matter how important the French Open championship is, Li is not resting on her laurels -- she's already thinking about winning a second major title. "When you have the first one, naturally you will think about the second one. Now I have more confidence playing on other surfaces," Li told China Daily, as she prepares for the Wimbledon Championship, which will start on June 20. [/INST] question: Which year did Li Na begin to study journalism? | options: A: In 2004 B: In 2002 C: In 2006 D: In 2000 | answer: B </s> |
<s>[INST] context: Remind children that bad things don't last. It may sound simple, but the message is extremely important. "Children often don't have the experience to know that when something bad happens---they lose an important game or their best friend lets them down---it's not the end of the world," explains Nancy Leffert, a senior research scientist with the Research Institute, an American adolescents and children's research group. "They think their bad feelings will last for ever, or that one failure will ruin everything."
Unfortunately, that kind of thinking discourages motivation . "If a child believes that the cause of her upset is lasting, or that nothing she does will make a difference, it decreases her ability to keep on trying." says Dorothy Rich, president of the MegaSkills Education Center of the Home and School Institute, based in Washington. Any time you can help your child see that a situation is not lasting, that a result can be changed, or that one opinion does not reflect reality, you give her reason to hope.
Case in point: "When my daughter Kathy was eight, art was one of her favorite subjects," says Beth, a mother of two. "Then she got an art teacher who gave a great deal of praise to one student and barely noticed the rest. Kathy was ready to give up until I explained to her, "Never stop doing your best just because one person doesn't give you praise." Beth had to repeat the advice often, and finally her daughter got the message. "Kathy is 12 now, and art is still one of her strongest subjects." [/INST] question: Which of the following is RIGHT about Nancy Leffert? | options: A: She is concerned about children's attitudes towards failure B: She is the president of the Education Center C: She strongly believes that bad things won't last long D: She is the director of the Research Institute | answer: A </s> |
<s>[INST] context: How much pocket money do you get from your parents every month--200 yuan?
Some may need more to buy birthday presents, ice cream or cartoon books.But for Li Hong,30 yuan each month is enough. The only thing she buys is lunch--1.5yuan each day."My favorite is noodles and rice." Said Li."But meat is too expensive for me."Li,14,is a student of Grade Eight. Her parents are migrant workers .They first came to Chongqing from a village in Henan two years ago.Her father now works as a cleaner and gets 500 yuan every month. Her mother has no job.Every day,Li gets up at 5:30 am and walks 50 minutes to get to school. She studies hard ,and even reads books during breaks! Her favorite subject is computer."I'm learning typing now. I hope to be the fastest in my class,"said Li. Like many teens, Li has lots of homework--- usually at last one hour every day. But that is not all he work. During the week she helps her mum cook. On weekends, she helps wash clothes. "I could cook when I was eight. Father said sometimes I cooked better than mum."
Li said she wanted to be a doctor when she grew up. "I wacth TV and find out
There are many people with AIDS in Henan. Some are kids.I really want to help them."Said Li.
But she is afraid of having to leave school.Li didn't go to school at the age of 12 one year because her family had no money to send her.This year, the school didn't ask her to pay the 600 yuan fees because her family is too poor."I hope I will always be in school,"said Li."Dad works hard to get money.I have promised him I will study hard to be a good student and a good doctor in the
future." [/INST] question: What does Li Hong's father do? | options: A: A housewife B: A cleaner C: A doctor D: A worker | answer: B </s> |
<s>[INST] context: Acetazolamide is a carbonic anhydrase inhibitor, which is found primarily in red blood cells. The red blood cells contain carbonic anhydrase that catalyzes the reaction that forms carbonic acid from CO2 andH2 O. Under high- altitude conditions, the inhibition of carbonic anhydrase will lead to a decrease in blood pH, which stabilizes the deoxygenated form of Hb. This is due to an increased loss of bicarbonate in the urine by the inhibition of carbonic anhydrase within the kidney. The change in pH increases oxygen delivery to the tissues and can overcome, in part, the symptoms of altitude sickness.However, in the case of the person with type I diabetes who begins to produce ketone bodies, the body's main compensatory mechanism to overcome the acidosis is blocked. As ketone bodies are formed and protons generated, the H+ will react with bicarbonate to form carbonic acid. Carbonic anhydrase, which catalyzes a reversible reaction, will then convert the carbonic acid to CO2 andH2 O, with the CO2 being exhaled. These reactions soak up excess protons and help to buffer against the acidosis. If, however, carbonic anhydrase has been inhibited by acetazolamide, then the bicarbonate cannot buffer the blood pH, and the acidosis could become more severe. White blood cells, muscle cells, liver cells, and the lens of the eye do not contribute to the buffering of the blood, and inhibition of carbonic anhydrase in those cells would not affect the ability to overcome an acidosis. [/INST] question: A patient is going skiing high in the Rockies and is given acetazolamide to protect against altitude sickness. Unfortunately, the patient is also a type 1 diabetic. He is admitted to the hospital in a worsening ketoacidosis. In which of the following cells has acetazolamide inhibited a reaction that has led to the severity of the metabolic acidosis? | options: A: White blood cells B: Red blood cells C: Lens of the eye D: Hepatocyte | answer: B </s> |
<s>[INST] context: On June 5, 1981 the Centers for Disease Control in Atlanta, U.S. announced the presence of a rare, infectious disease in five American homosexuals . Soon doctors were finding similar cases all over the country and the world. The AIDS epidemic had officially begun. By 1983 it was clear that AIDS had spread around the world. More than twenty years later, AIDS has left twenty-six million dead and another forty million infected. AIDS has become the worst medical disaster ever experienced by mankind.
Hundreds of young people between the ages of 20 and 45 died each week during the early years of the U.S. AIDS. More than 600,000 cases of AIDS have been reported since 1981 in the United States, and it is estimated that there may be as many as 900,000 Americans infected with HIV.
Though the rate of HIV infections continues to increase in the United States, the number of AIDS cases has fallen sharply since 1996, when antiretroviral drugs came onto the market. Unfortunately, the AIDS epidemic continues today in Africa and much of Asia, where antiretroviral treatment is not available and health care is far from enough. AIDS is the fourth leading cause of death worldwide, and the No. 1 cause of death due to infectious disease.
HIV, the virus that causes AIDS, was first separated in 1983 by a team at the Pasteur Institute in Paris. That discovery made it possible to develop a test for AIDS and trace back to victims who may have died before doctors were aware of the disease.
However, scientists still don't know exactly how and where AIDS started. Finding the source of AIDS could be important in developing a vaccine and be important in mapping the future course of the epidemic. [/INST] question: Which areas are the most worrying places where AIDS spreads quickly? | options: A: Africa B: Asia C: The United States D: France | answer: A </s> |
<s>[INST] context: Glyburide Glyburide is a second-generation sulfonylurea oral hypoglycemic. Of the main groups or chemical classes of oral antidiabetic agents, these are the ones typically associated with causing hypoglycemia, whether from overdose or as a rather expected response in some patients, paicularly before meals. Normally carbohydrates from a meal trigger insulin release; when blood glucose levels are low, as after the 18-h fast this patient experienced, physiologic insulin release would be low too. However, even in a fast-induced hypoglycemic state a sulfonylurea will release insulin and drive blood glucose down even fuher. The elderly are paicularly susceptible to sulfonylurea-induced hypoglycemia. Pa of this may relate to diet. However, expected age-related falls of renal and/or hepatic function can reduce elimination of these drugs, thereby increasing their serum levels and their effects unless dosages are reduced accordingly. This propensity for preprandial hypoglycemia is shared by the meglitinides, repaglinide and nateglinide because they, too, increase pancreatic insulin release. The thiazadolinediones (glitazones) seldom cause symptomatic hypoglycemia because they do not release insulin. The same applies to metformin, the biguanide; and acarbose (with, along with miglitol, is an aglucosidase inhibitor). Because of a longer half-life, compared with glipizide, a sulfonylurea is more likely to cause preprandial hypoglycemia. Glipizide is contraindicated in patients with liver disease because it is metabolized in the liver. Care should be taken in the elderly because of their propensity to develop hypoglycemia, which is perhaps due to decreased hepatic and renal function that is evident in this patient population. Metformin, acarbose, and pioglitazone do not produce serious hypoglycemic reactions. [/INST] question: A 75-yrs-old woman with diabetes is taking an oral antidiabetic drugs. One day she goes without eating for 18 h. Her serum glucose concentration is 48 mg/dL (hypoglycemic) upon arrival at the emergency depament, where she is deemed to be in critical condition. Which of the following drugs most likely aggravated this fasting hypoglycemia? | options: A: Acarbose B: Glyburide C: Metformin D: Pioglitazone | answer: B </s> |
<s>[INST] context: School Counseling
In our grandparents' time, it was unthinkable.In our parents' time, it was unusual and nobody spoke openly about counseling.These days, more and more schools are asking for this service and it is considered a necessity for most.Why is it? What has changed in the last fifty years to have made counseling at schools so important?
"One reason is that we expect schools to do more to protect their pupils than we did in the past," says school counselor, Mike Hudson." Also, our society doesn't work as well as it should.Many parents are either under pressure of work or face the economic problems of unemployment, while children are under more and more pressure to do well at school.Many pupils feel they are pushed to their limits by their parents and teachers."
Most school children face some kind of relationship problem at some stage with family members, teachers or other pupils, so.it helps to have somebody to talk to.
From the pupil' s point of view, it is easier to talk to a counselor in confidence rather than a family member or teacher.This solution is less embarrassing to pupils, who are not forced to face the person that they had problems with in the first place.They can calmly talk things through without arguments.
School counselors advise not only students but also their teachers and parents, and offer other services as well, such as deciding learning disabilities or assisting parents and guardians to make the correct decisions about their children' s education.
Counselors can help students with problems ranging from the most serious, like a death in the family, to what an adult would consider really trivial, like an argument with a friend.
In a society that is becoming more and more stressful, this service is providing children with a supportive way to express their fear and worries. [/INST] question: Why is school counseling becoming important? | options: A: Pupils are not well protected in school B: Parents can't help their children in learning C: Parents and pupils are under too much pressure D: The relationship between parents and schools is worse | answer: C </s> |
<s>[INST] context: Last week , US President Barack Obama visited upstate New York's Baseball Hall of Fame and Museum in an effort to highlight some of the United States' most-loved destinations and increase international tourism . " When it comes to tourism , we have a great product to sell , " he said . " Nothing says ' Made in America ' better than the Empire State Building or the Hoover Dam . "
According to statistics , a record 70 million international visitors travelled to the US in 2013 . But that was still only 13% of the world's travelers--a smaller market share than the 17% that visited the United States in 2000 .
Beyond the country's iconic locations--which travelers know all too well--the US is home to a great many charming and fascinating sights that often fly under the radar . Here are some of our favorites :
The wild woodlands of the Great Smoky Mountains
One of the oldest mountain rages in the world , this tranquil national park , which stretches across the Tennessee-North Carolina border , has a rich biodiversity that's equaled by few other places on the planet .
Texas : Home to the world's largest bat colony
Take nature watching to the extreme in the Lone Star State , where 1.5 million bats take flight over Austin every summer night .
Idyllic beach towns--without the crowds
Hidden away from the flood of summer travelers , these five little beach towns offer excellent surf spots , scenic views and Victorian charm .
Philadelphia's mosaic masterpiece
The city's downtown offers a one-of-a-kind artistic exploration , with 50,000sqft of tunnels , caves and walls covered in a bright and strange display of glass tiles , poetry and toys .
Kentucky : An adventure heaven
This state has one of the most amazing environments in the country , featuring both a rock climbing resort and the world's longest known cave system . [/INST] question: If you are interested in the cave adventure , you can go to _ . | options: A: Tennessee B: Kentucky C: Texas D: New York | answer: B </s> |
<s>[INST] context: "Some day, there'll be no Americans left in the NBA," said 12-year-old Xing Tao, who joined his school team two weeks ago after watching Yao Ming in a televised NBA game, "The players will all be Chinese, like Yao."
To China, Yao is a home-grown superstar who helped make the world's first basketball league closer to Chinese players. To the NBA, the 2.23-meter center offers an opening of a different sort into the world's largest new market. Yao's NBA first appearance against the Indiana Pacers in October reached 287 million families in the US. That game might have been a bit of a _ to Yao's fans: He played just 11 of the 48 minutes, had two rebounds and got no points. Comparing that with his performance on December 19, also against Indiana, Yao won 29 points and 10 rebounds. "This was one of the most exciting games I've had," Yao said after Houston's 95-83 victory. The NBA has to be excited about his on-count success. In all his games, he's averaging 12.7 points and 7.7 rebounds, quite good for a new star. "Yao Ming has brought the NBA closer to the Chinese," said NBA spokeswoman Cheong Sau Ching, "That makes the dream seem practical for other people in China and proud to be Chinese."
The 22-year-old Yao is not the country's first player in the NBA: Wang Zhizhi broke down the Dallas Mavericks in November 2003. But Yao's combination of modesty and skills make him a favorite back home. [/INST] question: How many points did Yao Ming win in his first game in the NBA? | options: A: zero B: two C: 29 D: 10 | answer: A </s> |
<s>[INST] context: It's summer movie time again. Check out our list of four films.
Harry Potter and the Prisoner of Azkaban
Release Date: November 4
Story: It's the summer before Harry Potter's third year at Hogwarts School of Witchcraft and Wizardry. A dangerous murderer, Sirius Black, has escaped from the Wizards' Prison. And he was ordered to kill Harry Potter.
Around the World in 80 Days
Release Date: November 16
Story: This version of the classic novel set in 1872 focuses on Passepartout ( Hong Kong actor Jackie Chan), a Chinese thief who seeks refuge with a strange London adventurer, Phileas Fogg. Passepartout uses his martial art skills to defend Fogg from danger as he travels around the world in 80 days.
Spider-Man 2
Release Date: November 30
Story: Peter Parker is still coming to accept his dual identity as the crime superhero Spider-Man. He wants to reveal his secret identity to Mary Jane, meanwhile, his Aunt May is in trouble. This is Dr Otto Octavius who has appeared to bring her a lot of troubles.
King Arthur
Release Date: November 7
Story: King Arthur is presented as a clever ruler who manages to unite all the knights in Britain. Under the guidance of Merlin and the beautiful, brave Guinevere, Arthur will struggle to realize his dreams. [/INST] question: When can you see the film acted by Jackie Chan? | options: A: November 4 B: November 30 C: November 16 D: November 7 | answer: C </s> |
<s>[INST] context: You've just come home, after living abroad away, has this country changed for the better-or
for a few years.Since you've been for the worse?
If you've just arrived back inthe UK after a fortnights holiday, small changes have probably surprised you-anything from a Iocal grcengrocer suddenly being replaced by a mobile-phone shop to someone in your street moving house.
So how have things changed to people coming back to Britain after seven, ten or even 15 year:' living abroad ? What changes in society can they see that the rest of us have hardly noticed ----or now take for granted ? To find out, we asked some people who recently returned.
Dcbi: When we IcCheltenham, my home town, was a town of white ,middle-class families-all very conservative .The town is now home to many eastern Europeans and lots of Australians, who come here mainly to work in hotel and tourism.There are even severai snops only for foreigners.
Having been an inunigrant myself, I admire people who go overseas to find a job.Maybe if I lived in an inner city where unemployment was high, I'd think differently, but I believe foreign settlers have improved this country because they're more open-minded and often work harder than the natives.
Christine: As we flew home over Britain, both of us remarked how green everything looked.But the differences between the place we'd left behind and the one we returned to were brought sharply into focus as soon as we landed.
To see policemen with guns in the airport for the first time was frightening-in Cyprus, they're very relaxed-and I got pulled over by customs officers just for taking a woolen sweater with some metal-made buttons out of my case in the arrivals hall.Everyone seemed to be on guard.Even the airport car-hire firm wanted a credit card rather than cash because they said their vehicles had been used by bank robbers.
But anyway, this is still a green, beautiful country.I just wish more people would appreciate w,that they've got. [/INST] question: After a short overseas holiday, people tend to _ | options: A: notice small changes B: expect small changes C: welcome small changes D: exaggerate small changes | answer: A </s> |
<s>[INST] context: It was nearly dark. The sun was dropping down the mountains far away. Little Tom came back home with tears in his eyes.
"What's the matter, Tom? How's your trip?" his mother asked with a big smile. "I failed. The mountain is so high and full of big or small stones on the way. I still go ahead. But I was tired and it was so late that I had to come back." Tom cried. "It doesn't matter. You are only 14 years old after all. You will have another chance ." his mother said. "But, standing at the top of the mountain is my dream!" Tom said. His father came over and asked, "Did you see the green trees on your way to the mountain?" "Sure, and there are a lot of beautiful flowers by the side of the road." Tom replied. "Did you hear the birds singing?" his father asked. "There are many kinds of birds singing in the trees, and the sound was very sweet." Tom said. "Did you feel the beauty of nature?" his father asked. "Yes, the blue sky, the white clouds, the green trees and the colorful flowers made a nice picture." Tom answered. "That's enough!" his father smiled and said, "Please remember, son. For often, achieving what you expect is not the most important thing. Although you didn't reach the top of the mountain, you got a lot on the way."
It is true that not every goal will be achieved, not every job will end up with a success, and not every dream will come true. The most beautiful scenery is on the way. [/INST] question: Tom got back home _ when the sun was dropping. | options: A: sadly B: slowly C: quickly D: early | answer: A </s> |
<s>[INST] context: The cauda equina is a structure within the lower end of the spinal column, that consists of nerve roots and rootlets from above.
Because the spinal cord stops growing in infancywhile the bones of the spine continue growing, the spinal cord in adults ends at about the level of the vertebra L1, and at birth at L3.
To get through the intervertebral foramen at the correct segment, the roots must travel down the length of the spine, thus gaining an oblique course.
Thai is why the spinal nerves are more &more oblique as we trace them from supero-inferiorly. For e.g., L-5 spinal nerve is more oblique as compared to T-5. Also, L-5 will be more in length as compared to T-5
Clinical relevance
Cauda equina syndrome is a serious neurologic condition in which there is compression of the contents of the spinal canal below the termination (conus) of the spinal cord.
Any lesion which compresses the cauda equina may cause dysfunction of the nerves although the commonest is a central disc prolapse.
Other causes include protrusion of the vertebra into the canal if weakened by infection or tumor and an epidural abscess or hematoma.
Signs include weakness of the muscles innervated by the compressed roots (often paraplegia), sphincter weaknesses causing urinary retention and post-void residual incontinence as assessed by catheterizing after the patient has voided.
Also, there may be decreased rectal tone; sexual dysfunction; saddle anesthesia; bilateral leg pain and weakness; and bilateral absence of ankle reflexes.
Pain may, however, be wholly absent; the patient may complain only of lack of bladder control and of saddle-anaesthesia, and may walk into the consulting-room. [/INST] question: A 26-year-old woman experiences severe back pain from an automobile accident. CT scan shows that the L5 vertebral foramen is completely obliterated by the collapsed L5 laminae and pedicles. In this injury, which of the following structures is crushed | options: A: Cauda equine B: Vertebral artery C: Filum terminale D: Denticulate ligament | answer: A </s> |
<s>[INST] context: The opioid antagonist naloxone reverses the effects of a dose of morphine or heroin within minutes. This may be life-saving in the case of a massive overdose. Naloxone administration also provokes an acute withdrawal syndrome in a dependent person who has recently taken an opioid. In the treatment of opioid addiction, a long-acting opioid (eg, methadone, buprenorphine ) is often substituted for the shoer-acting, more rewarding, opioid (eg, heroin). The signs and symptoms of withdrawal include a lot of distressing symptoms which makes the patient take the substance again. the symptoms of opiod withdrawl are remebered witha clue" ALL ORIFICES BLEED" the symptoms include rhinorrhea, lacrimation, yawning, chills, gooseflesh (piloerection), hyperventilation, hypehermia, mydriasis, muscular aches, vomiting, diarrhoea, anxiety, and hostility. the detoxification of opiod withdrawl is done by 3 methods that are listed below 1.SYMPTOMATIC DETOXIFICATION============clonidine, diazepam, dicyclomine, anti emetic, anti diarrhoeal 2.AGONIST ASOSIATED DETOXIFICATION========methadone, bupenorphine 3.ANTAGONIST ASSOSIATED DETOXIFICATION=====naltrexone STRONG OPIOID AGONISTS Morphineentanyl PAIAL AGONISTS CodeineHydrocodone MIXED OPIOID AGONIST-ANTAGONISTS BuprenorphineNalbuphine OPIOID ANTAGONISTS Naloxone [/INST] question: Methadone is used for opioid withdrawal because | options: A: Its antagonist at opioid receptor B: Its paial antagonist at opioid receptor C: Its agonist at opioid receptor D: Its paial agonist at opioid receptor | answer: C </s> |
<s>[INST] context: Most people agree that eating healthy food is important. But sometimes making good food choices can be difficult. Now, there are apps that can help people learn about the food they eat to improve their health and their dining out experience.
OpenTable app
OpenTable app helps people choose restaurants when they want to go out to eat. It is a free service that shows users restaurant available based on where and when they want to dine. It gives users points when they make reservations, which can add up to discounts on restaurant visits.
Max McCalman's Cheese & Wine Pairing app
Wine and cheese can be a great combination. But which wines go best with which cheeses? Max McCalman's Cheese & Wine Pairing app can help. It provides information about hundreds of different cheeses and suggests wines to pair with each. Max McCalman's Cheese & Wine Pairing app is free.
HappyCow app
Vegetarians do not eat animal meat. Vegans do not eat any animal products. The HappyCow app is made for both groups. Users can search for vegetarian-vegan restaurants and stores around the world.
LocalEats app
Restaurant chains, like McDonalds, can be found almost anywhere a person might travel. But sometimes travelers want to eat like locals. The LocalEats app is designed for that. It can help you find local restaurants in major cities in the US. and in other countries. It costs about a dollar.
WhereChefsEat app
Where Chefs Eat is a 975-page book. Most people would not want to carry that around. But there is a much lighter app version of the same name for just $15. Six hundred chefs provide information on 3,000 restaurants around the world on the WhereChefsEat app. [/INST] question: What can users get when making a reservation with OpenTable app? | options: A: prizes B: books C: points D: cheeses | answer: C </s> |
<s>[INST] context: This question is about an impoant drug interaction occurring between erythromycin and cisapride (used for gastroesophageal reflux disease- GERD). Serious cardiac arrhythmias, including torsades de pointes, QT interval prolongation, ventricular tachycardia, and ventricular fibrillation, have been repoed in patients taking cisapride with medications that inhibit cytochrome P450 3A4. Examples of medications other than cisapride that have a similar interaction with erythromycin include ketoconazole, fluconazole, clarithromycin, nefazodone, and indinavir. It is impoant to note that QT prolongation, torsades de pointes, cardiac arrest, and sudden death have occurred in patients taking only cisapride. None of the other agents listed interact with erythromycin to produce these proarrhythmic effects. Famotidine is an H2 receptor antagonist used in the treatment of GERD and gastric ulcers; this agent is generally well tolerated with very little incidence of drug interactions. Lansoprazole is a proton pump inhibitor indicated for the treatment of gastric ulcerations and GERD. When this agent is administered with phenytoin, the clearance of phenytoin is decreased by 15%, leading to an extension of the therapeutic effect. Metoclopramide is a prokinetic agent indicated for the treatment of GERD and diabetic gastroparesis. When given with cyclosporine, the toxic effects of cyclosporine are more pronounced. Fuhermore, when metoclopramide is administered with levodopa, it decreases the effectiveness of levodopa. [/INST] question: A 54-year-old man is brought to the emergency after experiencing several syncopal episodes. The patient states that he is currently taking erythromycin for treatment of bronchitis and another medication for treatment of gastroesophageal reflux disease (GERD). If an electrocardiogram reveals torsades de pointes, the patient is most likely taking which of the following medications for treatment of his reflux disease? | options: A: Cisapride B: Famotidine C: Lansoprazole D: Metoclopramide | answer: A </s> |
<s>[INST] context: "Recurrence is common, even though adequate excision of the track is carried out." - Bailey & Love "Once an acute episode has resolved, recurrence is common"- Schwartz 9/e p1067
Pilonidal disease
Pilonidal disease consists of a hair-containing abscess or chronic sinus, occurring in the intergluteal cleft.
It is an acquired disease
Although earlier it was thought to be a congenital disease, it is now considered to be an acquired infection of natal cleft hair follicles. The hair follicles become infected and rupture into the subcutaneous tissues to form a pilonidal abscess. Hair from surrounding skin is pulled into the abscess cavity by the friction generated by the gluteal muscles during walking.
More common in males
The incidence of pilonidal disease is more common in males (3:1 male: female ratio) between ages 15 & 40 with peak incidence between 16 & 20 yrs.
Pilonidal ds is more common in people with more body hair (hirsute). The ds. is almost rare in persons with less body hair.
Treatment of choice is surgery
Pilonidal sinus should be excised along with the secondary openings. (But only after controlling acute infection).
Acute pilonidal abscesses and sinus ds can be managed by simple incision and drainage (under local anesthesia). [/INST] question: Which is not a feature of pilonidal sinus: | options: A: Branching tracts are common B: Recurrence is uncommon C: Bony involvement is uncommon D: Seen in Drivers | answer: B </s> |
<s>[INST] context: Idioms are phrases and sentences that do not mean exactly what they say. Even if you know the meaning of each word you see or hear, you may not understand the idiom because you don't understand the culture behind it.
For example, if an American boy asks his mother what's for dinner tomorrow, she may say "I'll play it by ear", that means she doesn't have plans for dinner and she will decide later. "Play by ear" used to mean playing music using the sheet music, but now people often use it when they're not talking about music.
There're many idioms in English. If you learn to use them, your English will be more vivid and colorful. English idioms are more common in spoken English. They can be difficult to remember sometimes. Next time when you hear somebody saying to you, "Give me a hand", you don't necessarily stretch out your hand to him/her, but you do need to be helpful. And when the situation is out of hand, you usually can do very little to manage all that. What about a green hand? It's not about the color of your hand! You're a green hand when you are very new at your work and don't have much experience. If you and your partner always work together hand in glove, you two definitely work together very well.
Can you guess the meanings of some common English idioms to do with parts of your body? [/INST] question: An idiom is _ . | options: A: a phrase or a sentence that means exactly what the words say B: a phrase or a sentence that doesn't mean exactly what every word says C: so difficult that nobody can understand D: something to do with parts of your body | answer: B </s> |
<s>[INST] context: T11-T12 Pain pathways during labour The pain of labour arises from - Contraction of myometrium, against the resistance of cervix and perineum - Progressive dilatation of the cervix and lower uterine segment - Stretching and compression of pelvic and perineal structures Pain during the, first stage of labour is mostly visceral pain resulting from uterine contractions and cervical dilatation. It is usually confined to the T11-T12 dermatomes during the latent phase but eventually involves the TIO-LI dermatomes as the labour enters the the active phase. The visceral afferent fibres responsible for labour pain travel with sympathetic nerve.fibres.first to the uterine and cervical plexes then through the hypogastric and aoic plexes before entering the spinal cord with the T10-L1 nerve roots. The onset of perineal pain at the end of fist stage signals the beginning of the fetal descent and the second stage of labour. Stretching and compression of pelvic and perineal structures intensify the pain. Sensory innervations of the perineum is provided by the pudendal nerve (S2-S4) so pain during the second stage of labour involves the T10-S4 dermatosomes. [/INST] question: Prelabour pains are mediated through | options: A: Tit-T12 B: T2-L3 C: S1-S3 D: L3-L4 | answer: A </s> |
<s>[INST] context: A Guide
To use or protect all kinds of facilities in the library, follow the procedures given at the circulation desk.
Group Study Rooms(2F)
Students and teaching staff can use these rooms for group study. Students are advised to use unlocked rooms(4 rooms for 2 people, 3 rooms for 4 people) available for free. When you use locked rooms(2 rooms for 4 people, 2 rooms for 10 people), you need to go through reservation procedures at the circulation desk. These rooms are available for group discussion.
Individual Reading Rooms(1-3F)
There are 4 single rooms available for use by teaching staff and visiting scholars. Each room is equipped with a computer together 1 printer and 6 scanners. Reservation of these rooms is available for a period up to seven days on end.
Meeting Rooms and Seminar Rooms(1-3F)
Only teaching staff and graduate students can apply to use these rooms and reserve them one day in advance. The total number of seats is 40. They are available for workshops and small seminars.
Computer Rooms(4F)
These rooms are available for classes or seminars and so on. The total number of seats is 88. Only teaching staff can apply to use the computer rooms and reserve them one day in advance. [/INST] question: How many locked rooms can students and teaching staff use? | options: A: Two B: Three C: Four D: Seven | answer: C </s> |
<s>[INST] context: Success does not belong to a select group of individuals . Success belongs to those who are willing to go after it and try their best to do what they have to do. Here are some useful practical ways for you if you want to be a success.
Desire. Desire is the strong wish to achieve a goal. Without desire you have nothing. Before you can run with desire, your goal must be plain, clear, and it must also be exciting.
Show up. Seventy percent of success in life is showing up. You can't have a best seller, if you have never written a book. You can't get your dream job, if you're afraid to turn in an application. Showing up doesn't guarantee success, but if you don't show up, you won't succeed.
Fail. Unless you're willing to have a try, fail unhappily, and have another try, success won't happen. To have success you have to do things the right way, but often the only way to do something right is to first fail at it. As Thomas J. Watson said, a simple formula for success is to double your rate of failure . So welcome failure, become a student of failure, learn from failure, and soon you will succeed.
Work Harder. _ Success is not about doing what the common person can't do. It's about doing what the common person is unwilling to do. And on a deeper level, it's about creating habits that the common person is unwilling to create. It's the habit of doing things with excellence that causes success.
Enjoy the Journey. Success is a journey, not a destination . Success is not a certain car or a certain house or a certain happy marriage. Success is the enjoyment of the journey. You have to enjoy the journey.
Someone once said, "Unless you change how you are, you will always have what you've got." You have to change, you will change, and you will succeed. [/INST] question: Which of the following is NOT mentioned in achieving success? | options: A: Working hard B: Good education C: Strong desire D: Enjoying failure | answer: B </s> |
<s>[INST] context: Crowd controls could soon become an important skill for climbers on Mount Everest, as important as physical strength or watching the weather. In a single day last week, nearly 40 people reached the top of the world --- a record. Reports from base camp spoke of queues at dangerous ridges and crowds as people passed each other in the final dash for the 8, 848 meters top.
More traditional mountaineers tease about the circus atmosphere surrounding Everest in recent years, and there are warnings that the crowds are making the mountain more dangerous. In 1996, 14 died on the mountain when the members of several groups were trapped at high altitudes by sudden snowstorms. Bad weather in early May led to this year's jam on the summit ridge, but the loss, luckily, was light. Just four climbers died, including a Nepali Sherpa who had made 11 previous successful climbing.
Traditionalists are also worried about the growing tendency of climbers to set records and achieve "firsts", rather than simply climb the mountain. This year's crop of mountaineers included the oldest man, 64-year-old Sherman Bull from Connecticut, and the youngest, 16-year-old Temba Tsheri Sherpa of Nepal. An American with only one arm was on the mountain this year; an Indian with no legs also tried but failed. Erik Weihennieyer, an American, became the first blind person to reach the top of the world. His fellow climbers stayed in front of him on the way up, describing the type of land and ringing bells.
Nepal views Mount Everest as something of a cash cow. The government charges journeys a minimum of $ 70,000. That is probably why officials in Katmandu are ignoring concerns about overcrowding and talking about even more climbers coming next year. But a celebration of the 48th anniversary of the first conquest of Everest, by Sir Edmund Hillary and Sherpa Tenzing Norgay, was cancelled after violent strikes. Tumultuous Nepali politics, it seems, could be just the crowd-control measure that Everest needs. [/INST] question: What is the problem that the climbers have to face in recent years? | options: A: Bad Weather B: Technology C: Overcrowding D: Physical strength | answer: C </s> |
<s>[INST] context: It is obvious that doctors recognize obesity as a health problem. So why is it so hard for them to talk to their patients about it?
The results of two surveys, one of primary care physicians and the other of patients, found that while most doctors want to help patients lose weight and think it is their responsibility to do so, they often don't know what to say.
"So while doctors may tell patients they are overweight, the conversation often ends there," said Christine C. Ferguson, director of the _ . "Patients are not told about the possibility of diabetes ," she said. "And doctors don't feel they have good information to give. They felt that they didn't have adequate tools to address this problem.
The lack of dialogue hurts patients, too. The patient survey, of over 1,000 adults, found that most overweight patients don't even know that they're too heavy. Only 39 percent of overweight people surveyed had ever been told by a health care provider that they were overweight.
Of those who were told they were obese, 90 percent were also told by their doctors to lose weight, the survey found. In fact most have tried to lose weight and may have been successful in the past--and many are still trying, the survey found. And many understand that losing even a small amount of weight can have a positive impact on their health and reduce their risk of obesityrelated diseases like hypertension and diabetes.
Dr. William Bestermann Jr., medical director of Holston Medical Group, in Kingsport, Tenn. , which ranks the 10th in obesity among metropolitan areas in the United States, said the dialogue had to be an ongoing one and could not be dropped after just one mention of the problem. "If you're to be successful with helping your patients lose weight, you have to talk to them at actually every visit about their progress, and find something to encourage them and coach them," he said.
He acknowledged that many doctors tend to be not optimistic.
"Part of this is that there's this common belief, and doctors are burdened by it, too, that overweight people are weak-willed and just don't have any willpower and are selfindulgent and all that business," he said. "If you think that way, you're not going to spend time having a productive conversation." [/INST] question: How many of the patients surveyed have been advised by their doctors to lose weight? | options: A: About 350 B: About 390 C: About 900 D: About 1,000 | answer: A </s> |
<s>[INST] context: Rheumatoid ahritis (RA) is a chronic, systemic autoimmune disease that involves inflammation in the membrane lining of the joints and often affects internal organs. Most patients exhibit a chronic fluctuating course of disease that can result in progressive joint destruction, deformity, and disability. RA affects between 1 and 2 million Americans. It occurs three times more often in women, and peaks at age 35 to 50 years. Signs & Symptoms of RA Fatigue. Stiffness, especially in early morning and after sitting a long period of time. Not relieved by pain Low Grade Fever, Weakness. Muscle pain and pain with prolonged sitting. Symmetrical, affects joints on both sides of the body. Rheumatoid nodules. Deformity of your joints over time. Raynauds phenomenon. Pain Treatment objectives The goals in the management of RA are: 1. To prevent or control joint damage 2. To prevent loss of function 3. To decrease pain 4. To maintain the patient&;s quality of life 5. To avoid or minimize adverse effects of treatment. 6. Preservation of muscle and joint function. 7. Return to a desirable and productive life. ref : maheswari 7th ed [/INST] question: Patient is presenting with deformity of the finger as shown The PIP is involved but DIP is spared | options: A: osteoahritis B: Rheumatoid ahritis C: Psoriatic ahritis D: Ankylosing spondylitis | answer: B </s> |
<s>[INST] context: The Sieferts are the kind of environmentally conscious family who has solar panels atop their home. They use timers on their kids' showers and have planted drought-tolerant landscaping. But they feel kind of guilt. "I haven't thought about the pool as much as I probably should," said Annette Siefert.
As California's drought worsens, swimming pools have become a target for those who think the classic backyard greens waste water. Some water districts have banned new pools from being filled and have limited how much water existing pools can use.
But some of those agencies are walking back the rules as they make a surprising discovery: Pools aren't the water wasters some have made them out to be. Analyses by various water districts, along with scientific studies, conclude that pools and their surrounding landscapes use about the same amount of water as a lawn of the same size. Over time, pools might even use less water. With pool covers, experts say water evaporation can be cut by almost half, making pools significantly less wasteful than grass and about as efficient as drought-tolerant landscaping.
Facing complaints over a recent ban on filling pools, the Santa Margarita Water District conducted its own water-use analysis. It found that pools require thousands of gallons of water to fill initially, but they use about 8,000 gallons less water than a traditional landscape after that. By the third year, the analysis found, the savings add up, and a pool's cumulative water use falls below that of a lawn.
Water agencies such as the Los Angeles Department of Water and Power have come to similar conclusions. Armed with new information, Santa Margarita Water District officials will reconsider their ban next week.
"We want to respect the people's rights to use their property. There are many families we know that have saved for pools," said Jonathan Volzke, spokesman for the 155,000-customer district. "But at the same time, the reality around us is that we're in the third year of a serious drought, and we don't know if we're in the third year of a three-year drought or the third year of a 10-year drought." [/INST] question: Annette Siefert feels guilty mainly because of _ . | options: A: being a typical water waster B: the water-use of their swimming pool C: her control over her kids' showers at home D: the construction of the drought-tolerant landscaping | answer: B </s> |
<s>[INST] context: - The rate of NaCl delivery to the distal nephron significantly influences the RBF and GFR; the mechanism is called Tubuloglomerular (TG) feedback. The mechanism is based on 3 components: (i) A sensor: Cells in the macula densa. (ii) A signal: NaCl delivery to the distal tubule. (iii) An effector: Vascular smooth muscle cells within the wall of the afferent aeriole. When filtration increases, the increased NaCl delivery to the macula densa triggers vasoconstriction of the afferent aeriole. This results in a decrease in RBF and hence a decrease in GFR,reducing the NaCl delivery to the macula densa/distal tubules. The vasoconstriction is thought to be mediated by adenosine . If GFR and NaCl delivery to distal tubule are decreased, a decrease in ATP and adenosine formation occurs. There is the release of NO that produces vasodilatation, causing increased RBF and GFR. As more NaCl enters through the NKCC-2 transpoer located in the apical membrane (TAL), it stimulates the release of ATP through ATP-conducting ion channels located in the basolateral membrane of macula densa cells. This results in the opening of Ca2+ channels and an increase in intracellular , resulting in vasoconstriction and fall in GFR. Loop diuretics are known to blunt the TG feedback due to their action on the NKCC transpoer. [/INST] question: Tubuloglomerular feedback is initiated by delivery of: | options: A: Na+ to the macula densa B: Cl- to the macula dense C: NaCl to macula densa D: NaCl to the loop of Henle | answer: C </s> |
<s>[INST] context: Jerk test Repeat from May 09 Tests for Anterior shoulder instability Anterior shoulder drawer test- With the patient supine, the scapula is stabilized with one hand while the upper arm is grasped firmly with the other so as to manipulate the head of the humerus forwards and backwards (like a drawer). Apprehension test (Crank test) - this is a provocative test in which the examiner cautiously lifts the arm into abduction, external rotation and then extension, at the crucial moment the patient senses that the humeral head is about to slip out anteriorly and his body tautens in apprehension. Relocation test - this test involves placing the shoulder in the position of apprehension and applying a posteriorly directed force on the humeral head. The result is considered positive if this relieves the patient's apprehension. Fulcrum test- With the patient supine, the clinician takes the shoulder into 90 degrees abduction and adds lateral rotation and extension. The test indicates anterior instability if the patient becomes apprehensive. Tests for Posterior shoulder instability Jerk test- With the patient sitting and the shoulder abducted to 90 degrees and medially rotated, the clinician applies a longitudinal cephalad force to the humerus and moves the arm into horizontal flexion. A positive test is indicated if there is a sudden jerk as the arm is moved into horizontal flexion and as it is returned to the sta position. Posterior drawer test- The examiner passively displaces the huymeral head in a posterior direction. Pain, clicking, or an increase in humeral head translation indicates a positive test. Posterior apprehension test- The patient lies supine, with the shoulder flexed and internally rotated and with the elbow flexed and resting on the trunk. A posterior force is transmitted by the examiner through the subject's elbow. A look of apprehension and resistance to fuher movement constitutes a positive result. Push-pull test- The patient is positioned supine with the shoulder placed at a 90 degrees of scapular plane abduction. The examiner grasps the subject's wrist with one hand while the other hand is placed anteriorly near the humeral head. The examiner simultaneously pulls upward through the long axis of the forearm while pushing the humeral head posteriorly. A look of apprehension or displacement of the humeral head greater than 50% represents a postitive test. Circumduction test- The patient is in standing position. The examiner stands behind the patient grasping the patient's forearm with the hand. The examiner begins circumduction by extending the patient's arm while mainting slight abduction. As the circumduction continues into elevation, the arm is brought over the top and into the flexed and adducted postion. As the arm moves into forward flexion and adduction from above, it is vulnerable to posterior subluxation if the patient is unstable posteriorly. If the examiner palpates the posterior aspect of the patient's shoulder as the arm moves downward in forward flexion and adduction, the humeral head will be felt to subluxate posteriorly in a positive test. Jahnke test- A posteriorly directed force applied to the forward flexed shoulder. The shoulder is then moved into the coronal plane as an anterior directed force is applied to the humeral head. A clunk occurs as the humeral head reduces from the subluxed position. Tests for Inferior shoulder instability Sulcus sign- The patient stands with the arm by the side and shoulder muscles relaxed. The examiner grasps the patient's forearm below the elbow and pulls the arm distally. A positive test suggesting inferior instability of the shoulder is indicated if the patient's pain is reproduced and/or a sulcus appears distal to the acromian. [/INST] question: Posterior glenohumeral instability can be tested by: | options: A: Jerk test B: Crank test C: Fulcrum test D: Sulcus test | answer: A </s> |
<s>[INST] context: |TIBC, |Ferritin "A low serum iron & Ferritin with an elevated total iron binding capacity (TIBC) are diagnostic of iron deficiency." Iron deficiency anemia: * Iron deficiency is the single most prevalent deficiency state in the world. * An adult male absorbs & loses about l mg of iron from a diet containing 10-20 mg of iron daily. * During child bearing years, an adult female loses an average of 2 mg of iron daily & must absorb a similar quantity of iron in order to maintain equilibrium. * Growing children must obtain approx. 0.5 mg more iron daily. Plummer Vinson syndrome: * Is one of the manifestations of iron deficiency anemia. * It was described under the term "Hysterical Dysphagia" * This condition predisposes to development of carcinoma in the upper alimentary canal. * It is thought that the depletion of iron dependent oxidative enzymes may produce myasthenic changes in the muscles involved in swallowing mechanism, atrophy of the esophageal mucosa, & formation of webs as mucosal complications. Clinical manifestations: * Plummer Vinson syndrome occurs chiefly in females of 4th -5th decade of life. * Presenting symptoms of anemia & the syndrome are cracks, or fissures at the corner of the mouth (angular chielitis), a lemon tinted pallor of the skin. * A smooth, red painful tongue with atrophy of Filliform & later fungiform papillae. * There is dysphagia limited to solid foods, resulting from an esophageal stricture or web. * Koilonychia (spoon shaped fingernails) or nails that are brittle & break easily have been repoed in many patients. * Splenomegaly has also been repoed in 20-30% patients. Treatment: It responds well to iron therapy & a high protein diet. [/INST] question: In iron deficiency anemia, which of the following are seen in peripheral blood smear? | options: A: |TIBC, |Ferritin B: |TIBC, |Ferritin C: |TIBC, |Ferritin D: |TIBC, |Ferritin | answer: B </s> |
<s>[INST] context: It happened to me recently that I was telling someone how much I had enjoyed reading Barack Obama's Dreams From My Father and how it had changed my views of the current US President. The person I was talking to agreed with me that it was, in his words, "a wonderfully written book." However, he then _ to talk about Mr. Obama in a way that suggested he had no idea of his background at all. I sensed that I was talking to a book liar .
And it seems that he is not the only one. Clearly two thirds of people have lied about reading a book which they haven't. In The World Book Day survey, Dreams From My Father is at number 9. The survey lists top ten books, and various authors, which people have lied about reading. As I'm not one to lie too often, I'll admit here and now that I haven't read the entire ten books. But I am pleased to say that I have read the book at number one, George Orwell's 1984. I think it's absolutely outstanding.
Asked why they lied, the most common reason was to impress someone they were speaking to. This could be difficult if the conversation became more in-depth!
The World Book Day survey also has some other interesting information in it. It shows that many people lie about having read classical works by Jane Austen, the Bronte sisters, Charles Dickens and so on. But when asked which authors they actually enjoy, they named JK Rowling, Jilly Cooper, and Stephen King. Forty-one percent of people asked admitted they turned to the back of the book to read the end before finishing the story.
So which books have you lied about reading --if any -- and which is your favorite? [/INST] question: The main reason why people lie about reading is to _ . | options: A: make fun of the listener B: impress the listener C: please the listener D: interest the listener | answer: B </s> |
<s>[INST] context: Bisphosphonates inhibit bone resorption by binding to hydroxyapatite crystals on the bone surface. When osteo clasts attempt to resorb bone that contains bisphos phonate, the drug is released within the cell, where it inhibits key signalling pathways that are essential for osteoclast function. Although bisphosphonates prima rily target the osteoclast, bone formation is also sup pressed because of coupling between bone formation and bone resorption and an inhibitory effect on osteo blasts. However, the balance of effect on bone turnover is ourable, resulting in a gain in bone density due paly to increased mineralisation of bone. Bisphospho nate treatment typically leads to an increase in spine BMD of about 5-8% and in hip BMD of 2-4% during the f irst 3 years of treatment and plateaus thereafter. Alendronic acid is the bisphosphonate used most fre quently. It reduces risk of veebral fractures by 40% and nonveebral fractures by about 25% in postmenopausal women with osteoporosis. Risedronate is an alternative with similar efficacy, but may be better tolerated in patients with a history of gastrointestinal upset. Both drugs are effective in the treatment of coicosteroid induced osteoporosis. DAVIDSONS PRINCIPLES AND PRACTICE OF MEDICINE 22ND EDITION PAGE NO-1123 [/INST] question: TOC for post menopausal osteoporosis is- | options: A: Raloxifene B: Tamoxifene C: Estrogen D: Alendronate | answer: D </s> |
<s>[INST] context: Reiters syndrome/ flies singer-Leroy disease: traid of urethritis , ahritis conjunctivitis Genetic predisposition: hla b 27 Causative organisms: Chlamydia trachomatis Salmonella Campylobacter Yersinia Shigella Clostridium diff iCal eah Clinical features: chronological appearance First manifestations: urethritis,conjunctivitis Ahritis Circulate Balan it is Ahritis: asymmetric , oligoaicular-predilection to lower extremity large joints, enthesitis( inflammation of tendons and ligaments at the sites of inseion into capsule or bone),sacroilitis. Rapid development of massive effusions. Sausage digitis-diffuse swelling of solitary finger or toe Joints: early morning stiffness and pain. Genitourinary: nonspecific urethritis, cervicitis, cystitis, hematuria, hydronephrosis,prostatitis, baholinitis,vaginitis, salpingitis Eye lesions: conjunctivitis,uveitis,iridocyclitis Cutaneous: keratoderma blemorrhagicum-hyper keratotic pustular lesions on erythematous base involving palms and soles.crusted thick horny lesions with thick scales circulate Balanitis-most common irregular moist superficial erosions or ulcers coalesce to form circinate lesions. ulceration over tongue-painless Cardiac: aoic is and hea block Renal- glomerulonephritis Investigations: Elevated acute phase reactants Elevated esr Jointfluid-pseudo sepsis- neutrophils>50000/ul, with reiters cells Radiology: enthesitis with periosteum reaction, asymmetric sacroilitis, spondylitis, non marginal syndesmophytes Conditions to be differentiated from reactive ahritis Treatment Ahritis: Physiotherapy, nsaids,indomethacin is the drug of choice. Dmards-sulfasalazine, methotrexate,hydroxychloroquine,prednisolone,acitretin in hiv patients Biological: infliximab,etanercept Cyclosporine, levamisole,gold,pencillamine. Skin and mucus membranes: topical keratolytis, topical coicosteroids,methotrexate,acetretin Iadvl textbook of dermatology page 2088 [/INST] question: Genetic marker for reiters syndrome | options: A: HLA B8 B: HLA B5 C: HLA B27 D: HLA B19 | answer: C </s> |
<s>[INST] context: Enalapril Remember, The end result of drug metabolism is usually the abolition of activity of the drugs and conversion of drug from lipid soluble to water soluble compounds but sometimes the drug may be conveed from its inactive form to active form. Prodrugs Few drugs are inactive as such and need conversion in the body to one or more active metabolites. Such a drug is called a prodrug. The prodrug may offer advantage over the active form in being more stable, having better bioavailability or other desirable pharmaco-kinetic propeies or less side effects and toxicity. Prodrug Active form * Levodopa Dopamine * Enalapril Enalaprilat * S-methyldopa a methylnorepinephrine * Dipivefrine Epinephrine * Sulindac Sulfide metabolites * Hydrazide MAO Hydrazine derivatives inhibitors * Proguanil Proguanil triazine * Prednisone Prednisolone * Becampicillin Ampicillin * Sulfasalazine 5 Aminosalicyclic acid * Cyclophosphamide Aldophosphamide, Phosphoramide mustard * Fluorouracil Flourouridine monophosphate * Mercaptopurine Methylmercaptopurine ribonucleotide [/INST] question: Which is a prodrug ? | options: A: Enalapril B: Clonidine C: Salmeterol D: Acetazolamide | answer: A </s> |
<s>[INST] context: Polymyxin 8 and Colistin Polymyxin and colistin were obtained in the late 1940s from Bacillus polymyxa and B. colistinus respectively. They are active against gramnegative bacteria only; all except Proteus, Serratia and Neisseria are inhibited. Both have very similar range of activity, but colistin is more potent on Pseudomonas, Salmonella and Shigella. Mechanism of action They are rapidly acting bactericidal agents; have a detergent-like action on the cell membrane. They have high affinity for phospholipids: the peptide molecules (or their aggregates) orient between the phospholipid and protein films in gram-negative bacterial cell membrane causing membrane distoion or pseudopore formation. As a result ions, amino acids, etc. leak out. Sensitive bacteria take up more of the antibiotic. They may also inactivate the bacterial endotoxin. They exhibit synergism with many other AMAs by improving their penetration into the bacterial cell. ESSENTIALS OF MEDICAL PHARMACOLOGY K.D.TRIPATHI SIXTH EDITION PAGE NO:734 [/INST] question: Which of the following drugs is effective against pseudomonas infection? | options: A: Ampicillin B: Ceftriaxone C: Colistin D: Cefixime | answer: C </s> |
<s>[INST] context: Barbara was driving her six-year-old son, Benjamin, to his piano lesson. They were late. There was always so much to do, and Barbara, a night-duty nurse at the local hospital, had recently worked extra hours. She was tired.
"Mom!" Ben cried. "Look!" Just ahead, a car had lost control on the icy road and wildly rolled over, and then crashed into a telephone pole. Barbara went over. Thank goodness she was a nurse -- she might be able to help these unfortunate passengers. Then she stopped. What about Ben? She couldn't take him with her. Little boys shouldn't see scenes like this one. But was it safe to leave him alone?
For a little moment Barbara thought of going on her way. Someone else was sure to come along. No! "Ben, honey, promise me you'll stay in the car!" "I will, Mommy," he said as she ran.
Two girls of high school age were in the car. One was dead and the driver was still breathing. But if help came soon, the girl would live.
A trucker had pulled up and was calling for help on his cell phone. Soon Barbara heard the ambulance sirens .
Later, Barbara was able to meet the families of the victims . They expressed their gratitude for the help she had provided. [/INST] question: What did Barbara do? _ | options: A: A doctor B: A nurse C: A piano teacher D: A bus driver | answer: B </s> |
<s>[INST] context: No histamine release Cisatracurium is a stereoisomer of Atracurium Unlike atracurium cisatracurium does not produce a consistent dose dependent increase in plasma histamine -Atracurium triggers dose dependent histamine release that becomes significant at dose above 5mg/kg. - The release is dose dependent such that with increasing dose administered at the same rate there is greater propensity for eliciting histamine release. The histamine release resulted in:- - Flushing - Hypotension - Reflex tachycardia These effects are transient and the extent of hypotensive effect and reflex tachycardia were rarely of clinical significance. - Cisatracurium does not cause increase in histamine secretion, does not affect hea rate or blood pressure nor does it produce autonomic effects. Cisatracurium does not cause bronchospasmQ Atracurium use has been associated with bronchospasm and it should be avoided in patients with Asthma. To date cisatracurium has not been repoed to elicit bronchospasm at doses that are clinically prescribed Cisatracurium produces less laudanosineQ Laudanosine results from Hoffman elimination of Atracurium and cisatracurium Laudanosine may cause C.N.S. toxicity Cisatracurium produces less laudanosine Cisatracurium is 4 times as potent as Atracurium and produces less Laudanosine and has longer duration of intubation dose [/INST] question: Cis atracurium is prefferd over atracurium due to advantage of aEUR' | options: A: >Rapid onset B: >Sho duration of action C: >No histamine release D: Less cardiodepressant | answer: C </s> |
<s>[INST] context: When someone walks into a room wearing bright colours, everyone seems to take notice. Beautiful bright colours can easily draw our attention. Fresh roses can cheer us up when we're feeling blue. Dressing up in colourful clothing can bring us into a more positive mood.
What shall I wear today? What colour should I choose?
Dressing yourself for the day is quite important whether you know it or not. Our moods often show what our bodies end up wearing. When you look in the mirror after you dress, train yourself to notice how you feel when you see yourself. Notice your mood. If you are not feeling yourself, could the colour of what you are wearing irritate your nervous system? Did you never notice that before? We all know that dark colours can tell lies. They can make you look and feel older than you really are. That is why baby clothes never come in dark colours. To the mind, dark colours seem easier to hold power, but to the heart and feeling level, they don't help your heart to open. Bring happy colours and happiness to go hand in hand. Bright happy colours open your heart, calming your nervous system.
Some advice:
If you work around people who wear black, try to find a happy colour to look at to replace the picture of dark colours in your mind.
At night, wear soft clothes in light colours to help your nervous system calm down and smooth it out, preparing yourself for sleep.
Don't dress children in dark colours because their nervous systems are just beginning to feel. [/INST] question: What kind of colours can easily draw our attention? | options: A: All of the colours B: Dark colours C: Dark red D: Bright colours | answer: D </s> |
<s>[INST] context: The first ever trans-Atlantic telephone call was made from New York City to London in 1927. In keeping with this spirit, we'd like to tell you some of our other communication records:
* Most spammed person
Microsoft chairman William H.Gates III(the U.S.A.)receives up to four million spams each day. However, with the help of all the people who are working in Microsoft and anti-spam technology, only around ten spares reach his inbox per day.
* Earliest e-mail
In l971,Ray Tomlinson,an engineer at the computer company, and Newman in Cambridge, Massachusetts, the U.S.A. sent the first e-mail.At first it was an experiment to see if he could get two computers to exchange a message.(It was Ray who decided to use the @ symbol to separate the other's name from their location. The first e-mail message was "QWERTYUIOP")
* Largest LAN party
The largest LAN(Local Area Network)party was made up of 8531 unique computers and 9184 members in Sweden from 30 November to 2 December 2006.
* Most telephone books torsi in three minutes
Tina Shelton tore 21 telephone books at last, each with l028 numbered pages in a time of three minutes in California, the U.S.A. on 9 February 2007. [/INST] question: When was the first trans-Atlantic telephone call from New York to London made? | options: A: In2006 B: In l927 C: In l971 D: In l928 | answer: B </s> |
<s>[INST] context: It was Sunday morning. A butcher heard the doorbell and thought it must be a customer. But he was surprised to see that a dog was coming into his shop. The dog had $10 and a note in its mouth.
The butcher took the note and read it. It said,"10 pork chops , please."So the butcher took the money and put a bag of chops in the dog's mouth.
Then he quickly closed the shop because he decided to follow the dog. He found the dog on the street. The dog was waiting for a green light. Then the dog walked across the road. The dog went to a bus stop. When a bus arrived, the dog checked the number and then got on the bus.
After a while, the dog stood up on his back paws to push the "stop" button . The bus stopped and the dog got off. Then the butcher followed it to get off the bus.
The dog ran to a house and dropped the bag in front of the front door. It then began to beat its head against the front door. After a while, a big man opened the door and began shouting at the dog. The butcher ran up and shouted at the man, "What are you doing? Your dog is a genius ."
The owner of the dog said, "Genius? No way! I always tell him to take the keys when he goes to the stores. But he never listens to me!" [/INST] question: Who was the customer that Sunday morning? | options: A: A big man B: A butcher C: A dog D: A little boy | answer: C </s> |
<s>[INST] context: A back injury led Briton Rose Oliver to t'ai chi, which led her to her husband and then took both of them to China. But three years after moving to Shanghai to pursue their dream, Oliver's husband died, leaving her alone to follow their shared passion for t'ai chi.
Twenty years ago, Oliver's back injury ruined her childhood dream of becoming a ballet dancer. But the injury did lead her to t'ai chi, a martial art typically practiced in slow motion. Her initial hope was to improve her health. She later married her instructor, Rey Nelson, and founded a school with him, teaching the martial art to more than 10, 000 students over eight years.
The 49-year-old recalls the injury that left her bedridden for six months when she was 21 years old and with constant pain for decades.
"I was active and could not bear resting in bed," she recalls."But the soft tissue injuries were hard to heal. I thought I had to find some way to recover my health."
Oliver saw a poster for a t'ai chi class and decided to try the"mysterious exotic sport". She was struck by the beautiful movements and the"nice, patient instructor -- Nelson".
The couple later opened a t'ai chi school in the United Kingdom that attracted thousands of people. But they found themselves in a bottleneck.
"It was not enough for us to improve ourselves when we just learned from t'ai chi masters for two or four weeks a year,"she says. So the couple moved to Shanghai. They taught English in universities and happily learned t'ai chi under various masters. After years of practice, Oliver found her occasional backaches had disappeared.
In 2003, her husband's death brought her much pain. She thought of giving up, but considering the career in which her husband took pride, she stuck to it.
She says her t'ai chi"family"-- the masters and students -- also provided a great support network. Her then tutor was Dong Bing and Dong died in 2009 at the age of 88.
She speaks of their first meeting:"I had been told that his skill was of a very high level and for some reason I had a mental image of a powerful, big man. But my fellow pointed to a small, thin old gentleman, sitting on the ground.
"I felt amazed as I realized that this was the master himself, and then a sudden feeling of pleasure hit me. Of course this was exactly the kind of person who would be a t'ai chi master -- the last person you could imagine.
"I learned attentively from him. He did not only teach me physically t'ai chi but also the philosophy of how to be a better person, how to keep going when you felt you were tired.
"His idea is that one should not pursue wealth and fame but endeavor to be happy and share one's knowledge and wisdom with others."
Following the master, Oliver learned to live a simple life -- one perhaps more traditional than many Chinese. She does t'ai chi in the morning and makes kung fu tea for guests. Ink-wash bamboo paintings hang on her apartment walls.
Oliver spends her time outside t'ai chi teaching English and attending cultural exchange events.
She founded the Double Dragon Alliance in 2005. The organization enables Chinese kung fu masters to teach martial arts to Westerners and organizes seminars and events for them to experience Chinese massage , acupuncture , traditional medicine, calligraphy and tea ceremonies.
Because of her contribution to cultural exchange, Oliver was given the Shanghai Magnolia Award on Sept 30, 2013. The award, named after Shanghai's city flower, is given to foreigners who have made significant contributions to the city. [/INST] question: Oliver and her husband came to China in . | options: A: 2000 B: 2001 C: 2003 D: 2009 | answer: A </s> |
<s>[INST] context: Have you ever had an embarrassing experience? Last week we asked readers to tell us about embarrassing experiences. We received thousands of letters! Here is a selection.
Tony: My most embarrassing experience happened when I had just left university. I had just started teaching in a Liverpool secondary school. One morning my alarm clock didn't ring. I woke up at half past eight and school began at nine. I quickly washed, dressed, jumped into my car and rushed to school. When I arrived, the students had already gone into class. I didn't go to the office, but went straight into class. After two or three minutes the students began laughing, and I couldn't understand why! Suddenly I looked down and understood. I had put on one black shoe and one brown shoe!
Henry: The most embarrassing experience I've ever had happened two years ago. After seeing a film, my wife and I had lunch in our favorite restaurant in town. Then we decided to take a walk along the street. The street was very busy and we started holding hands. Suddenly my wife saw a dress in a shop window and stopped. I started looking at some watches in the next window. After a minute or two I reached for my wife's hand. There was a loud scream, and a woman slapped my face. I hadn't taken my wife's hand!I'd taken the hand of a stranger! [/INST] question: The students began laughing when they saw Tony _ . | options: A: wearing a wrong shoe B: carrying an alarm clock C: looking down suddenly D: rushing into the classroom | answer: A </s> |
<s>[INST] context: Assess the urethral injury by ascending ......... The bulbous urethra may be injured as a result falling astride an object. Urethral contusion may cause a perineal hematoma without urethral disruption. Perineal hematoma usually resolves without complications. Laceration will lead to urinary extravasation. The patient usually has a desire to void, but voiding should not be allowed until assessment of the urethra is complete. No attempt should be made to pass a urethral catheter, but if the patient's bladder is over distended, percutaneous suprapubic cystostomy can be done as a temporary procedure. A urethrogram with instillation of 15 - 20 m1 of contrast material, will demonstrate extravasation and the location of injury. The contused urethra will show no evidence of extravasation. If there is no evidence of extravasation on the urethrogram, a urethral catheter may be passed into the bladder. Extravasation is a contraindication to fuher instrumentation at this time. After the urethrography, the patient with urethral contusion is allowed to void; and if the voiding occurs normally, without pain or bleeding no additional treatment is necessary. If bleeding persists urethral catheter drainage can be done. If urethral laceration is detected on urethrography instrumentation of the urethra should be avoided. A suprapubic cystostomy tube should be inseed (through a small incision in the suprapubic area to expose the dome of the bladder) to allow complete urinary diversion while the urethral laceration heals. [/INST] question: A 35-year-old engineer presented with bleeding from external meatus and perineal hematoma, after he fell astride on a scaffolding, half-an-hour back. The patient had not passed urine since the accident. On physical examination there was no evidence of extravasation of urine and the bladder was not distended. What would be the immediate management? | options: A: Encourage him to pass urine after adequate control of pain B: Assess the urethral injury by ascending urethrography C: Percutaneous suprapubic catheterization of the bladder D: Catheterization of the urethra | answer: B </s> |
<s>[INST] context: Listening to music while you drive can improve your speed and ability to get away from accidents, according to Australian psychologists. But turning your car radio up to full volume could probably make you end up in an accident. The performance of difficult tasks can be influenced if people are subjected to loud noise. The experience of pulling up at traffic lights alongside cars with loud music made some psychologists in the University of Sydney look into whether loud music has something to do with driving.
The psychologists invited 60 men and women aged between 20 and 28 as subjects and tested them on almost the same driving tasks under three noise conditions: silence, rock music played at a gentle 55 decibels , and the same music at 85 decibels.
For 10 minutes the subjects sat in front of a screen operating a simple machine like a car. They had to track a moving disk on screen, respond to traffic signals changing color1, and brake in response to arrows that appeared without warning.
On the tracking task, there was no difference in performance under the three noise conditions. But under both the loud and quiet music conditions, the performers "braked" at a red light about 50 milliseconds sooner than they did when there was no rock music at all. That could mean a reduction in braking distance of a couple of meters actually, the difference between life and death for a pedestrian.
When it came to the arrows that appeared across the visual field, the psychologists found that when the music was quiet, people responded faster to objects in their central field of sight by about 50 milliseconds. For the people listening at 85 decibels, response times were dropped by a further 50 milliseconds -- a whole tenth of second faster than those "driving" with no music.
"But there's a trade-off," the psychologists told the European Congress of Psychology. "They lose the ability to look around the whole situation effectively." In responding to objects that suddenly appeared, people subjected to 85-decibel rock music were around 100 milliseconds slower than both the other groups. Since some accidents -- such as children running into the road -- take place without any notice, drivers listening to loud music must be less safe as a result. [/INST] question: Where did the researchers do the experiment? | options: A: At crossroads B: At a police traffic station C: In a crowded street D: Under the experimental conditions as those of the streets | answer: D </s> |
<s>[INST] context: Four most Extreme Travel Destinations in the World
Coldest Inhabited Place on Earth: Oymyakon, Russia
As the coldest inhabited place on earth, the small Russian town of Oymyakon was once only used as a location for political prisoners. Winter temperature average at about -58 degrees F, the ground is frozen all year long. Popular sports include skiing, ice hockey and ice fishing.
Closest Place to Outer Space: Mount Chimborazo, Ecuador
Mount Chimborazo stands at over 20,000 feet high. Standing on it will put you closest to outer space that man can ever reach on foot. Its peak is completely covered by glaciers, but this mountain has several routes for climbers.
Hottest Place on Earth: Lut Desert, Iran
Here, temperatures reach as high as 158 degrees F. Though tourists visit this desert land, it's a destination only for those willing to take on the challenge of surviving the heat and the dry climates.
Most Isolated Place on Earth: Tristan da Cunha, United Kingdom
Looking for a getaway from the everyday? This is about as far away from it as you can get. The island is home to fewer than 300 inhabitants and has no airport, Tristan da Cunha is accessible only by sea. [/INST] question: Oymyakon was once used as a location for political prisoners probably because it _ . | options: A: is isolated and cold B: was covered by glaciers C: is hot and deserted D: is a getaway for people | answer: A </s> |
<s>[INST] context: Surgical treatment of Salivary malignancies The primary treatment of salivary malignancies is surgical excision. In this setting, basic surgical principles include the en bloc removal of the involved gland with preservation of all nerves unless directly invaded by tumor. For parotid tumors that arise in the lateral lobe, superficial parotidectomy with preservation of CN VII is indicated. If the tumor extends into the deep lobe of the parotid, a total parotidectomy with nerve preservation is performed. Although malignant tumors may abut the facial nerve, if a plane of dissection can be developed without leaving gross tumor, it is preferable to preserve the nerve. If the nerve is encased by tumor (or is noted to be nonfunctional preoperatively) and preservation would result leaving gross residual disease, nerve sacrifice should be considered. The removal of submandibular malignancies includes en bloc resection of the gland and submental and submandibular lymph nodes. Radical resection is indicated with tumors that invade the mandible, tongue, or floor of mouth. Therapeutic removal of the regional lymphatics is indicated for clinical adenopathy or when the risk of occult regional metastasis exceeds 20%. High-grade mucoepidermoid carcinomas, for example, have a high risk of regional disease and require elective treatment of the regional lymphatics. When gross nerve invasion is found (lingual or hypoglossal), sacrifice of the nerve is indicated with retrograde frozen section biopsies to determine the extent of involvement. If the nerve is invaded at the level of the skull base foramina, a surgical clip may be left in place to mark the area for inclusion in postoperative radiation fields. The presence of skip metastases in the nerve with adenoid cystic carcinoma makes recurrence common with this pathology. Postoperative radiation treatment plays an impoant role in the treatment of salivary malignancies. The presence of extraglandular disease, perineural invasion, direct invasion of regional structures, regional metastasis, and high-grade histology are all indications for radiation treatment. [/INST] question: Surgical treatment of parotid tuimor nvolving the deep lobe is ? | options: A: Total parotidectomy with facial nerve preservation B: Total parotidectomy with facial nerve sacrifise C: Sub total parotidectomy D: Subtotal parotidectomy with facial nerve sacrifise | answer: A </s> |
<s>[INST] context: Our environment isn't as green and beautiful as it should be. There are steel monsters blocking out the sun, blowing out dangerous smoke, and letting out poisonous chemicals into rivers, cars producing harmful waste gas, people throwing out waste in a wrong way and all other kinds of sources that ruin the planet. Facing current environmental problems, people need to do their best to save the Earth.
You can see many big garbage dustbins in the streets. They're not there for a show, but for you to drop your waste. We should realize that what a little we do does count. So next time you get that urge to throw gum or a chocolate package out of the car window, or " accidentally" drop as you walk down the street, ask yourself how much waste you've been contributing to the environment with that bad habit going on for years.
At home, the first thing we can do to protect the environment is avoid letting water run continuously and make sure that taps are not leaky ,which would help greatly in _ Another is to use energy-saving lights, and turn them off before you leave the rooms. It's not only energy-saving, but also cuts down electricity costs.
Recycling is a method to make items reusable. Many things you want to throw out can be made into new products through the reproducing process. Use your imagination to come up with ways on things that you can use again.
Pass the message of simple ways to save the environment on to kids. Starting with kids is a good way of teaching the message early in their lives, in the hope that they can carry it forward as they grow older.
With environmental protection awareness in mind, we can do what we can, for the results are to have a big effect on the planet. As long as we do our part, the world is one small step closer to being saved. [/INST] question: Which of the following isn't true? | options: A: The more people do their part, the greener the environment will be B: Selling what you don't want any more is a kind of recycling C: To protect the environment may help you save some money D: Your bad habits for the environment are a valuable contribution | answer: D </s> |
<s>[INST] context: New Education is the UK's first training company devoted to the development of leadership potential in cross-cultural environment, We provide high quality training services such as effective communication, public speaking, positive attitude, life planning, career skills, Chinese and Western cultural differences and traditional Chinese business wisdom.
New Education was set up in April 2010, with headquarters in London, Our professional services are divided into personal training and corporate training.Personal training is mainly for students, professional and business managers.Corporate training is mainly for Chinese companies with branches in the UK and foreign companies interested in China.
With our deep understanding of Chinese and Western environment and high-quality training techniques, we can provide excellent professional services.Our goal is to become the best learning partner for individuals and companies seeking for overseas success.
Our training team is composed by the elites from various industries.In addition to our professional training skills and techniques, and our rich experience, we are willing to devote ourselves to helping others improve themselves and seek for success.
Easterners and Westerners are very different in their ways and means to explain concepts and information, which is important in our personal trainings.Our main value lies in the combination of the western theories and practice in individual development and the Chinese people's habits, ways of thinking and the practical problems in cross-cultural background, to effectively help you in improving your overseas competitiveness and achieving your goals. [/INST] question: The advantage of New Education lies in its _ . | options: A: learning environment B: location C: reputation D: leadership potential | answer: A </s> |
<s>[INST] context: Is traditional fairytales good all the time? Recent research found one in five parents have abandoned those old classics such as Snow White and the Seven Dwarves and Hansel and Gretel and they're in favor of more modern books.
One third of parents said their children have been left in tears after hearing the terrible details of Little Red Riding Hood. The survey of 2,000 adults was carried out to mark the launch of the hit US drama GRIMM, which starts tonight at 9:00 pm on Watch, and sees six series based on traditional fairytales. The research found a quarter of parents wouldn't consider reading a fairytale to their child until they had reached the age of five, as they cause too many awkward questions. And 52 percent of the parents said Cinderella didn't send a good message to their children as it portrays a young woman doing housework all day. Similarly, Goldilocks and the Three Bears was also a tale likely to be left on the book shelf as parents felt it condones stealing.
Steve Hornsey, General Manager of Watch, said: "Bedtime stories are supposed to relax the children and send them off to sleep soundly. But as we see in GRIMM, fairytales can be dark and dramatic tales so it's understandable that parents worry about reading them to young children. As adults we can see the innocence in fairytales, but a five year old with an over active imagination could think they are true. Despite the dark nature of classic fairytales, as we see in GRIMM, good will defeat evil and there is always a moral to the story."
Though half of parents said traditional tales are more likely to have a strong moral message than a lot of modern kids' books, two thirds of mums and dads said they were no longer appropriate to soothe youngsters before bed. On the contrary, they might give their children nightmares. [/INST] question: Which of the following is TRUE about the recent research? | options: A: Steve Hornsey General Manager of Watch led the research B: 20% parents thought old classics aren't fit for modern children C: People like more modern books because old classics are out of date D: About 30% parents were moved to tears after hearing some classic fairytales | answer: B </s> |
<s>[INST] context: A Nobel Prize is considered by most people one of the highest international honours a person can receive. As you know, the prizes were started by a Swede called Alfred Nobel. He was born in Stockholm, the capital of Sweden. Alfred Nobel was a great scientist. He made two important inventions, and so he became very rich. Although he was rich, Nobel was not a happy man. He never married or had children. Also, he was a sick man during his large part of life. When he died at the age of 63, he left a fund of $9,000,000. The money was to be used in giving prizes to those who made great achievements in physics, chemistry , medicine and literature , and for world peace.
The first Nobel Prizes were given on December 10, 1901, five years after Nobel's death. Since then many famous people from all over the world have been given Nobel Prizes for their achievements.
Each prize has three parts. The first part is a gold medal. Second, a winner of a Nobel Prize is given a certificate saying that he has been given the prize. The third part of the prize is a large amount of money-about $40,000.
Often a prize is given to just one person, but not always. Sometimes a prize is shared. It may be given to two or more people who have worked together. It is also sometimes true that a prize is not given at all if there is no great achievement. In 1972, for example, no Nobel Peace Prize was given. [/INST] question: When was Alfred Nobel born? | options: A: In 1938 B: In 1833 C: In 1896 D: In 1906.[ | answer: B </s> |
<s>[INST] context: Name: Container Gardens by Number
Cover price: $l5.95
Our price: $9.49
A book covers 50 easy-to-follow container designs. Each design provides a simple numbered planting plan that shows exactly how to create each display, with an instruction of the finished container and in-depth plant information. The plans are easy to follow and for any type of living space or garden.
Name: Off the Beaten Path
Cover price: $30.00
Our price: $l9.80
The best-selling Reader's Digest travel book has 40% new content including over 200 new places of interest, over 200 new full-color photographs, and all-new, up-to-date maps. It introduces over l, 000 of the United States' most beautiful must-see sights.
Name: l80l Home Treatment
Cover price: $40.00
Our price: $29.96
Plenty of health problems can be solved at home. Each and every treatment will be tested by a doctor to make sure it is safe and sound.
Lots of conditions are covered, from headaches, sunburn and bad breath to hiccups .
Name: Best Weekend Projects
Cover price: $l7.95
Our price: $l3.96
Choose from 80 ideas to create an unusual living space. The projects are practical, as well as attractive, and will improve your home and yard and can be made in a weekend. These 80 well-designed projects are presented in a clear, easy-to-follow style. [/INST] question: How much money can you save if you want to buy a medical book? | options: A: $6.46 B: $l0.20 C: $l3.96 D: $l0.04 | answer: D </s> |
<s>[INST] context: On May 28th, 1998 I was driving my 13-year-old daughter and 14-year-old son to school. Unfortunately my car crashed with a truck. All three of us were critically injured. Stacey's brain injury was the most severe. Despite all attempts to save her, she died two days later. When I became conscious, I heard my husband talking to the organ donor coordinator .
We knew that Stacey would want that because that's the kind of person she was. She always wanted to assist people. She was always smiling and brought so much joy to others. She was friendly and enjoyed writing stories and poetry.
It has been a comfort to know that Stacey lives on in the lives of others. I have even met the family of one of Stacey's kidney recipients . This little girl was 6 years old at the time of the transplant. She was suffering from Nephrotic Syndrome. I saw pictures showing the effects of the Nephrotic Syndrome and the pictures of her after the transplant. _ already showed an amazing difference. We correspond every year through letters, cards and pictures. The girl is doing really well at school and will be graduating from high school next year. I am so grateful that we have this relationship. I also feel relieved that my daughter has made so great a difference to a person's life.
Over the years, I have had some kind of contact with all of the recipients except the heart recipient. I'm very sorry for that. I would love to hear something from the heart recipient's family. There are so many things that I wonder about her. I wonder if she is anything like Stacey. Does she smile all the time? Does she enjoy writing stories and poetry? I do hope that they can contact us!
I feel guilty because I was the one driving in the accident which caused Stacey's death. I also feel proud that my daughter has helped so many people. [/INST] question: When did Stacey die from the traffic accident? | options: A: On May 28th, 1998 B: On May 29th, 1998 C: On May 31st, 1998 D: On May 30th, 1998 | answer: D </s> |
<s>[INST] context: (Fat -embolism) (855-56-CSDT 12th) (178-Anaesthesia- A. yadav 3rd)FAT-EMBOLISM - Fracture through a large marrow filled cavity almost inevitably results in small showers of fat emboli being swept to the lungs. This can usually be accommodated without serious consequences, but in some cases (and especially in those with multiple injuries and severe shock or in patients with associated chest injuries) it results in progressive respiratory distress and multi - organ failure (ARDS)* Blood gases should be measured soon after admission, and may suspicious signs such as shortness of breath, restless ness or a rise in temperature or pulse rate should prompt a search for petechal hemorrhages over the upper body axillae and conjunctivae* TRIAD of fat embolism - Dyspnea, confusion and petechial haemorrhage.* Capnography show fall in endtidal CO2 (ETCO2 may become zero if embolus is large enough to block the main pulmonary artery* Coagulation abnormalities like increased clotting time and decreased platelets* Serum lipase is increased* Air embolism - occure during the placement or removal of central venous catheters* Amniotic fluid-embolism - occur during active labour* Fat embolism - occur from long bones fractures- Characterised by respiratory insufficiency, Coagulopathy, encephalopathy and an upper body petechial rash* Pulmonary embolism - results from septic emboli, tumour emboli from atrial myxoma or IVC extension of renal cell carcinoma and parasitic emboli**DVT remains the most common source of pulmonary thromboembolism [/INST] question: A young male presented with dyspnea, bleeding and petechial hemorrhage in the chest after 2 days following fracture shaft of the femur right side. Most likely cause is | options: A: Air embolism B: Fat embolism C: Pulmonary thrombo embolism D: Amniotic fluid embolism | answer: B </s> |
<s>[INST] context: option-1-Naegleria fowleri: 1. Acute and fulminating primary amoebic meningoencephalitis (PAM) is caused by Naegleria fowleri. 2. Clinical features of N. fowleri: typical feature of meningitis with rhinitis are seen .The key to diagnosis is clinical suspicion based on recent history of swimming or diving in warm waters. NAEGLERIA FOWLERI ACANTHAMOEBA BALAMUTHIA Causes PAM(primary amoebic meningoencephalitis) Infective form -amoeboid form * Resides in fresh water pond * History of swimming in fresh water pond Flagellated forms-enter nares-cribriform plate-brain-PAM * So called "brain eating amoeba" Causes encephalitis-contact lens keratitis -optic route-Granulomatous encephalitis Aerosol route- lungs- brain - granulomatous encephalitis Causes granulomatous encephalitis option-2- Acanthamoeba species have been isolated as etiologic agents in Acanthamoeba keratitis: A. castellanii, A. polyphaga,. option-3- Disease: Granulomatous amebic encephalitis and Ulcerative keratitis option-4-E. histolytica and Entamoeba coli do not cause meningoencephalitis. [/INST] question: A 30yr old patient presented with features of acute meningoencephalitis in the casualty. His CSF on wet mount microscopy revealed motile unicellular microorganism. The most likely organism is - | options: A: Naegleria fowleri B: Acanthamoeba castellani C: E. histolytica D: Ent. Coli | answer: A </s> |
<s>[INST] context: NEW YORK-- The band Atomic Tom has scored an Internet hit with its self-created video to the song Take Me Out. In the video, the band members ride a New York City subway while performing entirely on iPhones, with applications linked with mini-battery powered broadcasters for each instrument.
Singer Luck White says the production was a top-secret operation.
"We didn't tell anyone about this. It was completely top-secret from our family, from our friends, from management, from everybody. So the first time that people saw this video was last Friday when we put it on YouTube,"explained White.
It has been watched by more than 2 million on YouTube since debuting last week. "All I've wanted to do for the past few days is just stare at the YouTube page and keep refreshing it to see how far it will go, " said Espiritu, the lead guitarist of the band.
"The Internet changed everything,"Espiritu said. "It's kind of an exciting time because it forces everyone to adjust and be creative and find new ways to get your name out there."
The idea for the video came from Espiritu's 24-year-old brother Benjamin, who's hoping to go to film school. " I've seen a lot of these music applications, and they're kind of fascinating to me,"Benjamin Espiritu said. " I thought: 'What would happen if iPhones kind of took over the world? If there could actually be a band that played straight through with iPhones, what would that look like?'" So they shot the video --with iPhones also serving as video cameras. The band also tried Union Square but were stopped during playing because they didn't have a permit.
" _ ,"Espiritu said. "We've seen the jump." Their album has been in the top 10albums on iTunes.
Will their fans start cheering for iPhone-only performances? "We've gotten the most exposure and teh most fans that we've ever gotten through this, so I wouldn't be surprised if fans are going to want to see that.: Espritu said. [/INST] question: Who first saw the ban's video to the song Take Me Out? | options: A: Their friends B: Their family C: The people online D: Their management | answer: C </s> |
<s>[INST] context: Facial nerve paralysis is a daunting potential complication of parotid surgery. Knowledge of the key landmarks of the facial nerve trunk is essential for safe and effective surgical intervention in the region of the parotid gland. In current practice, wide ranges of landmarks are used to identify the facial nerve trunk, however, there is much debate in the literature about the safety and reliability of each of these landmarks Major surgical landmarks to the facial nerve include the tympanomastoid suture line, the tragal pointer, the posterior belly of the digastric muscle. the retromandibular vein, and the styloid process of the temporal bone. The tympanomastoid fissure- The most used anatomical landmark is the tympanomastoid fissure. The tympanomastoid fissure lies between the mastoid and tympanic segments of the temporal bone. The facial nerve lies approximately 6-8 mm medial to suture. The Tragal pointer the nerve is usually located inferior and medial to the Tragal pointer of the external auditory canal, about 10mm. The Digastric muscle The facial nerve lies just superior and on the same plane as the plane of digastric muscle attachment. If the main trunk of facial nerve cannot be readily identified, retrograde dissection of a branch of facial nerve can be used. The buccal branch is best for this approach. In the infant and young child, these landmarks are not applicable because of differences in the rate of anatomic development of the parotid gland and mastoid. [/INST] question: Which of the following is not a landmark for facial nerve during parotid surgery ? | options: A: Digastric muscle B: Inferior belly of omohyoid C: Tragal pointer D: Retrograde dissection of distal branch | answer: B </s> |
<s>[INST] context: What will city life be like in the future? Some people think that life in the cities is going to be horrible. They say that cities will become more and more crowded. As the number of people increases, there will be less space for each person. This overcrowding will cause other problems -- more crime, dirtier streets , and worse problems with traffic than we have now. How will people find enough drinking water, energy (such as gas and electricity ), and housing? Because life will be hard, people who live in cities will worry more, and they may become sick. For these reasons, some say that nobody will want to live in city areas.
How can we deal with such problems as overcrowding, crime, and traffic? In some cities, thousands of people are already sleeping in the streets because there is little suitable housing -- and because houses are too expensive. The crime rate isn't going down. Instead, it is increasing so fast that many people are afraid to go out at night. Traffic is also getting worse. More and more often, traffic jams are so bad that cars don't move at all for several streets. These problems have been getting worse, not better, so many people see no hope for the future of the city.
Los Angeles, California, for example, has no subway system and buses are slow. Instead, many commuters (, ) drive many miles from their homes to work. Many of these drivers spend several hours each day on busy freeways. New York, however, has a big transport system -- buses, commuter trains, and subways. Because the public transportation is crowded and dirty, many people drive private cars, and the traffic jams are worse than that in Los Angeles. A taxi driver complains, "I was driving home, but in forty-five minutes I moved only two miles! Finally, I turned off the engine and just sat there. A lot of people left their cars where they were in the middle of the street and went into a bar for a few beers!"
On the other hand, some cities have clean, fast and pleasant public transportation systems. In Paris, France, and Toronto, Canada, for example, anyone can use buses or subways to move quickly from one part of the city to another. [/INST] question: What do some people think is the main problem of the future city like? | options: A: Poor housing B: Overcrowding C: Environmental pollution D: Traffic jams | answer: B </s> |
<s>[INST] context: “A variety of ovarian neoplasms, both benign and malignant may produce testosterone and lead to virilization. Specifically, women with an abrupt onset, typically within several months, or sudden worsening of virilizing signs should prompt concern for a hormone producing ovarian or adrenal tumor. Symptoms may include deepening of voice, frontal balding, severe acne or hirsutism or both, increased muscle mass and clitoromegaly. Accordingly, serum testosterone levels may be used to exclude these tumors. Free testosterone levels are more sensitive than total testosterone levels as an indicator of hyperandrogenism. Although improving, current free testosterone assays lack a uniform laboratory standard. For this reason, total testostrerone levels remain the best approach for excluding a tumor. Threshold values beyond 200 ng /dl of total testosterone warrant evaluation for an ovarian leison.”
So now I do not need to explain that testosterone estimation is the best investigation in case of rapid onset hirsutism and amennorhea.
Lines of Leon Speroff further support the answer—
“A serum testosterone concentration greater than 150 mg/dl identifies almost all woman with a potential androgen producing tumor.
However, a tumor still should be suspected and excluded in a woman with rapidly progressive hirsutism or signs and symptoms of virilization, even when the serum testosterone concentration is below the threshold value.”
M/C cause of rapid onset hirsutism in young females = Testosterone producing tumor
DHEA sulphate is produced exclusively by the adrenal gland. Therefore, serum DHEAS levels above 700 mcg/dl are highly sensitive for the presence of an adrenal neoplasm.
Adrenal imaging with abdominal CT or MRI is indicated for any patient with DHEAS levels that exceed this value. [/INST] question: Kali Rani a 20-year-old girl presents with history of rapidly developing hirsutism and amenorrhea. To establish the diagnosis you would like to proceed with which of the following tests in blood: | options: A: 17 - OH progesterone B: DHEA C: Testosterone D: LH: FSH ratio | answer: C </s> |
<s>[INST] context: About Pre-op shaving Bailey writes - "Pre-op shaving should be avoided except for aesthetic reasons or prevent adherence of dressing. If it is to be done, it should be undertaken immediately before surgery as there is a higher infection rate when it is performed the night before, because minor skin injury enhances superficial bacterial colonisation."
Farquharson op. surgery also supports the above view and writes that pre op shaving can be done to get a clear view but it does not reduce infection.
Steps for Reducinj Wound infection
1) Prophylactic antibiotics
is based on the concept that bacterial contamination occurs during surgery, and that the administration of the antibiotic used for prevention must be timed for optimal blood levels during the operations.
antibiotics are administered by intravenous route at the time of induction of anaesthesia
Monofilament sutures are used over polyfilament sutures to prevent infection.
Proper apposition of the wound and prevention of any dead space and hematomas.
Proper washing of hands with a detergent solution containing added chlorhexidine or an iodine based antiseptic.
Bowel preparation for intraabdominal surgeries
Skin preparation with an antiseptic solution
Elimination of any foreign body or dead tissue from the wound. [/INST] question: Prevention of wound infection is done by :a) Pre op shavingb) Pre op antibiotic therapyc) Monofilament sutured) Wound apposition | options: A: abc B: acd C: ac D: bcd | answer: D </s> |
<s>[INST] context: Myelofibrosis with myeloid metaplasia is a myeloproliferative disorder that is also a stem cell disorder in which neoplastic megakaryocytes secrete fibrogenic factors leading to marrow fibrosis. The neoplastic clone then shifts to the spleen, where it shows trilineage hematopoietic proliferation (extramedullary hematopoiesis), in which megakaryocytes are prominent. The marrow fibrosis and the extramedullary hematopoiesis in the spleen fail to regulate orderly release of leukocytes into the blood. The peripheral blood has immature RBC and WBC precursors (leukoerythroblastic picture). Hematopoietic cell proliferation and turnover increases purine metabolism and uric acid production. Teardrop RBCs are misshapen RBCs that are seen when marrow undergoes fibrosis. Marrow injury also can be the result of other causes (e.g., metastatic tumors, irradiation). These causes also can give rise to a leukoerythroblastic picture, but splenic enlargement with trilineage proliferation usually is not seen. The other causes mentioned - Hodgkin lymphoma, portal hypertension, and Histoplasma capsulatum infection - can cause splenic enlargement, but not marrow fibrosis. Metastases to the spleen are uncommon. [/INST] question: A 66-year-old man has experienced fatigue, a 5-kg weight loss, night sweats, and abdominal discomfort for 10 months. On physical examination, he has marked splenomegaly; there is no lymphadenopathy. Laboratory studies show hemoglobin, 10.1 g/dL; hematocrit, 30.5%; MCV, 89 gm3; platelet count, 94,000/mm3; and WBC count, 14,750/mm3 with 55% segmented neutrophils, 9% bands, 20% lymphocytes, 8% monocytes, 4% metamyelocytes, 3% myelocytes, 1% eosinophils, and 2 nucleated RBCs per 100 WBCs. The peripheral blood smear also shows teardrop cells. The serum uric acid level is 12 mg/dL. A bone marrow biopsy specimen shows extensive marrow fibrosis and clusters of atypical megakaryocytes. Which of the following is most likely to account for the enlargement in this patient's spleen? | options: A: Extramedullary hematopoiesis B: Granulomas with Histoplasma capsulatum C: Hodgkin lymphoma D: Metastatic adenocarcinoma | answer: A </s> |
<s>[INST] context: Roseola infantum caused by human herpes virus 6 (d) leads to seizures in 15% of symptomatic infants. In healthy infants, the infection is asymptomatic or follows the course described in the vignette. In immunocompromised children, the abrupt onset includes CNS and other organ system involvement. Following infection, the virus remains latent in lymphocytes and monocytes. Infection in adults or reactivation in adulthood may produce a mononucleosis-like syndrome with lymphadenopathy and hepatitis. In immunocompromised patients such as bone marrow, kidney, and liver transplant patients, much more serious infections/reactivations occur that may lead to organ rejection and death. Erythema infectiosum (a), hand-food-and-mouth disease (b), measles (c), and rubella (d) (caused by the viruses indicated in the choices) each present differently: "slapped cheek" reticular rash 7 to 10 days following a nonspecific prodrome; vesicles appearing on the hands, and disseminated maculopapular rashes beginning on the neck, respectively. [/INST] question: An 8-month-old girl suddenly developed a high fever (103degF). Her pediatrician examined her and found no signs of upper respiratory tract infection, meningitis, or encephalitis. Two days later, the girl's fever reached 105degF and she suffered a febrile seizure. By the time the child was brought to the pediatrician's office, her temperature had dropped. The doctor noted a generalized papular rash. What was the doctor's most likely diagnosis for this child? | options: A: Erythema infectiosum caused by parvovirus B19 B: Hand-foot-and-mouth disease caused by Coxsackievirus A C: Measles caused by Morbillivirus D: Roseola infantum caused by human herpes virus 6 | answer: D </s> |
<s>[INST] context: Laboratory diagnosis of HIV infection
Laboratory diagnosis is made by:
A. Antibody detection
It is the most common method used for diagnosis of HIV infection.
ELISA is the most sensitive test and therefore is the screening test of choice.
Western blot is the most specific (Confirmatory) test and therefore is the’gold standard’ for diagnosis.
Antibodies test usually nucleic acid or antigen.
B. Detection of HIV nucleic acid or antigen
P24 antigen detection by ELISA can be done 16 days after infection (earlier than antibody detection).
Nucleic acid detection tests are the earliest to become positive (12 days after infection), Most commonly used test is reverse transcriptase PCR, (RT-PCR), other methods used are DNA-PCR, RNA-PCR, RNA-bDNA (branched DNA), and RNA-NASBA (nuclei acid sequenced based assay).
C. Virus isolation
Co-cultivation of the patient’s lymphocyte with uninfected lymphocytes in the presence of IL-2.
Not suitable as a routine diagnostic procedure.
In infected individual HIV can be isolated from
Blood
Semen
Saliva
Urine
Lymphocytes
Cervical secretions
Tears
Breast milk [/INST] question: A person has unprotected sex 3 weeks back, To rule out HIV infection the best test is | options: A: P 24 antigen assay B: ELISA C: Western blot D: Lymphnode biopsy | answer: A </s> |
<s>[INST] context: IELTS: international English language testing system
Introduction: The IELTS is jointly managed by the University of Cambridge Local Examination Syndicate , the British Council and IDP Education Australia
Why more and more people are taking the IELTS test?
The IELTS test is widely recognized by the colleges, universities and other academic institutions of Australia, New Zealand, Canada and the United Kingdom. More and more universities and colleges in the US are also accepting an IELTS result as a language requirement for application to degree courses.
IELTS is accepted by many important organizations, such as the New Zealand Immigration Bureau, the Australian Immigration and Cultural Department, the Canadian Immigration Bureau, the Australian Medical Council and the British Medical Association .
Choice of two test types
There are two test models: Academic and General Training. The candidate must select the one suitable to his/here purpose for taking the test.
Academic: for candidates who want to apply for undergraduate or postgraduate courses.
General Training: for candidates who take IELTS for immigration purpose, training programmes, or work experience.
If you have any questions about which type to take, consult the Examinations Services staff at the British Council offices.
Content
The test is composed of four papers: Listening, Reading, Writing and Speaking. The first three papers must be taken at one sitting on one day, and the speaking paper may be taken up to two days later. Usually in China, the Listening paper is taken on a Saturday morning, followed by the Reading paper, and then Writing paper. The Speaking test is usually taken on the Saturday afternoon or on the following Saturday. Candidates must complete all four papers in order to obtain an overall score. [/INST] question: How many organizations is IELTS managed by? | options: A: 6 B: 5 C: 4 D: 3 | answer: D </s> |
<s>[INST] context: Australia, the last continent, was discovered by ships belonging to some European nations in the seventeenth century. These nations were less interested in changing it into a colony than in exploring it. As in the early history of the United States, it was the English who set up the settlements in Australia. This history and the geography of these two British colonies have some other things in common as well.
Australia and the United States are about the same in size, and their western lands are both not rich in soil. It was the eastern coast of Australia and American that the English first settled, and both colonies soon began to develop towards the west. However, this westward movement took place more because the English were searching for better land than because the population was increasing. Settlements of the western part of both countries developed quickly after gold was discovered in America in 1849 and in Australia two years later.
Although the development of these two countries has a lot in common, there are some striking differences as well. The United States gained its independence from England by revolution while Australis won its independence without having to go to war. Australia, unlike the United States, was firstly truned into a colony by English prisoners and its economic development was in wheat growing and sheep raising. By 1922, for example, Australia had fifteen times more sheep than it had people, or almost half as many sheep as there are people today in the United States. Yet, in spite of these and other main differences, Australia and the United States have more in common with each other than either one has with most of the rest of the world. [/INST] question: Who turned Australia into a colony? | options: A: Britain B: Several European countries C: The United States of America D: None of the above | answer: A </s> |
<s>[INST] context: In American schools there is something called Homecoming Day.Many high schools and colleges with a football team have a homecoming game. This can be the most important event of the year, except for graduation.Students plan it for many weeks in advance.
Several days before Homecoming,students begin to decorate the school.There are signs to wish luck to the team and many other signs to welcome back the graduates from other years.Many people still come to Homecoming twenty or thirty years after they graduate.
The members of school clubs sell delicious foods and fruits,such as apples and sandwiches.Some clubs even help to welcome visitors.
During the day people like to look for teachers that they remember from long ago.Often they see old friends and they talk together about those happy years in school.
Everyone soon comes to watch the football game. When the game is half over,the band comes onto the field and plays school songs.Another important moment is when the Homecoming Queen appears.All the students vote a most popular student Homecoming Queen or King.It is a great honor to be chosen as the Homecoming Queen or King.
Homecoming is a happy day, but it is not perfect unless the football wins the game.Even if the team loses,the students still enjoy Homecoming.Some stay at the school to dance,and others go to a party.For everyone it is a day to remember for a long,long time. [/INST] question: Where do people spend Homecoming Day? | options: A: At home B: At restaurant C: At the school D: At a stadium | answer: C </s> |
<s>[INST] context: Victoria Avenue School supports the Walking School Bus initiative a safe, healthy and fun way for children to walk to and from school, guided by a registered group of parents. If you and your child would be interested in joining one of our buses we would love to hear from you.
Bell Road route
This is a morning bus with over 30 walkers! The route is as follows: Starts at 14 Bell Road, down Scherf Road, crosses Portland Road into Ingram Street, left into Spencer Street then to school. Please call Vanessa McNaught at 5234529.
Lingarth / Mahoe route
This bus runs morning and afternoon. It departs from the corner of Combes Road and Lingarth Street at 8:10 am. There are two routes-one goes along Lingarth Street and the other along Mahoe Avenue and Manawa Road at 8:25 am. The bus continues up Manawa Road, turns right into Victoria Avenue, and goes down Dragon Drive. At the end of the school day all walkers meet at the bottom of Dragon Drive, leaving school at approximately 3:10 pm. Please contact Toko Kofoed tokofoed@gmail. com.
Shore Road route
We gather together at Hapua Reserve at 8:15 am and depart at 8:20 am. We walk along Shore Road to Stirling Street and then up Stirling Street to school. Please contact Nicky Hall nicky. hall@simpsongrierson. com.
Spencer Street starwalkers
The route begins at the crossing of Aldred Road and Spencer Street leaving at 8:20 am.The bus then crosses Glenbrook Street and continues along Spencer Street reaching the school. Please contact Victoria Nicholls victorian@ pascoes. co. nz.
Shera Road route
Currently this bus is not running. Those living in Shera Road, Leys Crescent and Portland Road are welcome to register your interest in taking this bus. We hope to have the bus running in the autumn, when it will travel along Portland Road, up Ingram Street and left into Spencer Street. Pease call Vanessa McNaught at 5234529. [/INST] question: Part of Bell Road route is similar to _ . | options: A: Lingarth/Mahoe route B: Shera Road route C: Shore Road route D: Spencer Street starwalkers | answer: B </s> |
<s>[INST] context: A twisted sense of humor and a strong voice cast make "Open Season" fun for kids and adults. It's a great start for Sony's animation studio.
Boog is a full-grown grizzly bear that has been raised among humans by park ranger Beth. He has a warm place to live, all the food he wants, and is safe from hunters.
However, when he crosses paths with the spastic mule deer Elliot, all that changes. Thanks to a series of misunderstandings, everyone believes Boog is dangerous and out of control. Beth is forced to release him back into the wild.
Once Boog finds himself in the great outdoors, he has no idea what to do. He gets lost, can't find food, and is attacked by unfriendly forest cutters. Boog is forced to rely on the idiotic Elliot to help him find his way back to civilization . But can they _ before open season begins for hunting?
The movie also has a really strong voice cast. Martin Lawrence voices Boog, and his attitude and persona perfectly fit the bear. The same goes for Aston Kutcher as Elliot. Even if you can't stand him in the real world, you'll be surprised how well he brings the annoying deer to life in the movie.
The animation in "Open Season" is also excellent. The characters are quite cartoonish, but the hair is realistic looking and the movements are fantastic. The body language adds a lot to the performances of the characters. [/INST] question: What's the key factor that the Boog need to survive himself in the wild? | options: A: He wants to seek a comfortable settlement B: It's thought that the Boog is beyond control C: The Boog is required to find enough food D: The Boog is eager to make new friends | answer: B </s> |
<s>[INST] context: Sunnyside School Bookshop Sunnyside Secondary School
A Warm Welcome To All Secondary Pupils! Congratulations on getting into Singapore's premier school. To do well in English, you must have a good English dictionary. May we recommend that you buy any of these two, which have been specially selected by the English teachers in the school. Select the one that fits your needs!
Foster's Advanced Learners' Dictionary
The most authoritative and up-to-date dictionary for intermediate learners of English.
* Over 50,000 references, including new words created over the past ten years.
* 20 full-page colour illustrations.
* Grammar and spelling rules simply and completely explained.
* Lots of examples of how to use words in the correct context.
* l0-page appendix on "How To Write More Effectively".
Active Learners' English Dictionary
A most useful dictionary which not only helps you to learn new words but also shows you different ways of using them in your writing. Particularly useful for foreign students and non-native speakers of English!
* Over 48,000 references with explanations focusing on a speaker's attitude and intentions.
* Each definition together with tips on how to use the word or its synonyms in the correct context.
* Right margin gives a list of synonyms.
* Left margin gives information on grammar and spelling.
* Clear pronunciation guide. [/INST] question: The purpose of the notice is to _ . | options: A: educate the pupils B: welcome new pupils C: advertise the bookshop D: make sales | answer: D </s> |
<s>[INST] context: Apoptosis results from the activation of enzymes called caspases (so named because they are cysteine proteases that cleave proteins after aspaic residues). The activation of caspases depends on a finely tuned balance between production of pro- and anti-apoptotic proteins. Two distinct pathways converge on caspase activation: the mitochondrial pathway and the death receptor pathway pro-apoptotic members of the family called Bax and Bak, which dimerize, inse into the mito- chondrial membrane, and form channels through which cytochrome c and other mitochondrial proteins escape into the cytosol. These sensors also inhibit the anti-apoptotic molecules Bcl-2 and Bcl-xL (see fuher on), enhancing the leakage of mitochondrial proteins. Cytochrome c, together with some cofactors, activates caspase-9. Other proteins that leak out of mitochondria block the activities of caspase antagonists that function as physiologic inhibitors of apop- tosis. The net result is the activation of the caspase cascade, ultimately leading to nuclear fragmentation. Conversely, if cells are exposed to growth factors and other survival signals, they synthesize anti-apoptotic members of the Bcl-2 family, the two main ones of which are Bcl-2 itself and Bcl-xL. These proteins antagonize Bax and Bak, and thus limit the escape of the mitochondrial pro-apoptotic proteins. Cells deprived of growth factors not only activate the pro-apoptotic Bax and Bak but also show reduced levels of Bcl-2 and Bcl-xL, thus fuher tilting the balance toward death. ref Robbins 9/e p19 [/INST] question: Which of the following is an antiapoptotic gene? | options: A: BAX B: BAD C: BCL-X D: BIM | answer: C </s> |
<s>[INST] context: Nearly 28% of college Students plan to seek employment using Linkedin, up from 5% last year, according to a survey out today from employee recognition provider i Love Rewards and career-services network Experience.Slightly more than 7% plan to use Facebook, up from 5%.
No longer do students just wait for visiting campus recruiters to learn about job possibilities.Instead they're using digital tools to find their dream jobs, says I Love Rewards CEO Razor Suleman.Companies need to know their online image, then update anything that is outdated, inaccurate or not inleractive .
'The recruited have now become the recruiters," Suleman says."They are now going out and finding the companies they want to apply for."
Students learn about employers by viewing their websites, reading Facehook and Twitter updates and perusing Linkedln profiles.Another information source: Comments by past and current employees on job-oriented websites.
A strong digital presence is one way for employers to stand out as the search for the best and brightest gets competitive.
Slightly more than four in 10 employers say they will use "different" recruiting tactics to reach Generation Y, according to a survey by job-search site Monster.com to be released today.Of those respondents, almost 60% say social-networking sites are popular tools to reach Gen Y candidates.
"Our reason for using social media is because that's where we think the candidates are," he says.
The company posts updates and videos on topics such as job opportunities and the benefits of being an employee.It also created a mobile-friendly site for those who want to apply via smart phone.
"Younger people want to attach to you in a different way than the past," Lavery says."They want to interact with you.They want to learn about you."
The updated recruitment techniques take effort, but they work, he says.
In 2010, UPS used those tactics to _ 955 employees.The year before, it hired 29 employees through those means.
"It's a time investment that you have to be willing to do," he says."You can't just have a page up there and not have content.In social media, you have to have a give and a take, or people won't be a part of your community." [/INST] question: In order to find their dream jobs, more American graduates like to use _ . | options: A: newspapers B: magazines C: the Internet D: radios | answer: C </s> |
<s>[INST] context: "My dream has come true.I have always wanted to be a Grand Slam champion." These are the words of the Chinese tennis player Li Na after she became the first Asian woman to win the Australian Open final on Jan.25th.2014.
"People were saying I'm getting old.So this is a great success for such an old woman." the 32-year-old girl joked.
Miss Li has a tattoo . She has dyed her hair many different color1s.And, at the 2008 Beijing Olympics, she told her fans to "shut up" when they got too noisy in their support.
Li Na was born in Wuhan.She started to play tennis at the age of 6.She once recalled: "As a child. I suffered a lot because every day I had to wake up early to practice.After school I had to practice more.I didn't have time to play."
Luckily, the strong girl didn't give up. thus making history for Chinese tennis time after time.Now the new champion is already thinking about winning another Grand Slam title."When you have one title, surely you will think about another," she says. not hiding her ambition.
"Chinese people are so lacking in confidence on the tennis court.If there is a person like me who can prove we Chinese can do it, the other young players in China will feel the same." she said. [/INST] question: Li Na began to learn playing tennis in the year of _ . | options: A: 1988 B: 1982 C: 1986 D: 1990 | answer: A </s> |
<s>[INST] context: Prevention of influenza
1. Immunization
Three types of vaccines are available :
a) Killed vaccine - most commonly used
b) Live attenuated - Administered as nasal drops
c) Newer vaccines - Split virus vaccine (sub-virion vaccine)
Used subcutaneously
Recombinant vaccine
Neuraminidase vaccine
A trivalent, live attenuated influenza vaccine administered as a single dose intranasal spray is a effective as inactivated vaccine. It is approved for use in otherwise healthy individuals between the age of 2 years and 49 years.
2. Chemoprophylaxis
Type A → Amantadine and rimantidine
Both Type A & B → Zamamivir, Osteltamivir
The current recommendations are that influenza A be treated with zanamivir or a combination of oseltamivir and rimantadine. Influenza B can be treated with either oseltamivir or zanamivir.
For chemoprophylaxis against influenza A, Zanamivir should be used. If this is contraindicated, rimantidine should be given. For influenza B, oseltomivir is used.
Following information has been added in 22nd /e of Park
Oseltamivir is the drug of choice for chemoprophylaxis of influenza A (H1N1) 2009 for health care personnel’s and close contacts of suspected, probable or confirmed case of pandemic influenza A (H1N1) 2009. [/INST] question: Newer Influenza vaccine -a) Split-virus vaccineb) Neuraminidase c) Live attennuated vaccined) Killed vaccine | options: A: ac B: a C: ad D: ab | answer: D </s> |
<s>[INST] context: DYSTROPHIC CALCIFICATION METASTATIC CALCIFICATION Seen in Dead/Degenerative tissue Seen in Living tissue Affected Patients will have normal serum Ca2+ Affected Patients will have Hypercalcemia Causes of dystrophic calcification TB Chronic abscess Infarcts Atherosclerosis Hematoma Tumors like meningioma,mesothelioma Myositis ossificans Psammoma bodies Causes of metastatic calcification Hyperparathyroidism Parathyroid adenoma Hypervitaminosis D Rickets Seen in:- RHD Atherosclerosis Papillary carcinoma of thyroid, ovary, salivary gland Myositis ossificans, Meningioma Seen in:- Hyperparathyroidism Vit D Intoxication SarcoidosisMilk alkali syndrome Metastasis (Multiple myeloma) Myositis ossificans: It's a type of connective tissue metaplasia. It is seen after a traumatic injury. Due to the presence of degenerative muscle tissue, patient is going to have dystrophic calcification. Metastasis and sarcoidosis both undergo Metastatic calcification, there is increased serum Ca2+ seen in both the conditions. [/INST] question: Dystrophic calcification is seen in which of the following conditions? | options: A: Myositis ossificans B: Paget's disease C: Metastasis D: Sarcoidosis | answer: A </s> |
<s>[INST] context: Davidsons Principles and practice of medicine_22Edition page no 623-624 Aoic regurgitation Aetiology and pathophysiology This condition is due to disease of the aoic valve cusps or dilatation of the aoic root (Box 18.109). The LV dilates and hyperophies to compensate for the regurgitation. The stroke volume of the LV may eventually be doubled or trebled, and the major aeries are then conspicuously pulsatile. As the disease progresses, left ventricular diastolic pressure rises and breathlessness develops. Clinical features Until the onset of breathlessness, the only symptom may be an awareness of the hea beat . paicularly when lying on the left side, which results from the increased stroke volume. Paroxysmal nocturnal dyspnoea is sometimes the first symptom, and peripheral oedema or angina may occur. The characteristic murmur is best heard to the left of the sternum during held expiration. a thrill is rare. A systolic murmur due to the increased stroke volume is common and does not necessarily indicate stenosis. The regurgitant jet causes fluttering of the mitral valve and, if severe, causes paial closure of the anterior mitral leaflet, leading to functional mitral stenosis and a soft mid-diastolic (Austin Flint) murmur. In acute severe regurgitation (e.g. perforation of aoic cusp in endocarditis), there may be no time for compensatory left ventricular hyperophy and dilatation to develop and the features of hea failure may predominate. In this situation, the classical signs of aoic regurgitation may be masked by tachycardia and an abrupt rise in left ventricular end-diastolic pressure; thus, the pulse pressure may be near normal and the diastolic murmur may be sho or even absent. Investigations Regurgitation is detected by Doppler echocardiography . In severe acute aoic regurgitation, the rapid rise in left ventricular diastolic pressure may cause premature mitral valve closure. Cardiac catheterisation and aoography can help in assessing the severity of regurgitation, and dilatation of the aoa and the presence of coexisting coronary aery disease. MRI is useful in assessing the degree and extent of aoic dilatation. Management Treatment may be required for underlying conditions, such as endocarditis or syphilis. Aoic valve replacement is indicated if aoic regurgitation causes symptoms, and this may need to be combined with aoic root replacement and coronary bypass surgery. Those with chronic aoic regurgitation can remain asymptomatic for many years because compensatory ventricular dilatation and hyperophy occur, but should be advised to repo the development of any symptoms of breathlessness or angina. Asymptomatic patients should also be followed up annually with echocardiography for evidence of increasing ventricular size. If this occurs or if the end-systolic dimension increases to 55 mm or more, then aoic valve replacement should be undeaken. Systolic BP should be controlled with vasodilating drugs, such as nifedipine or ACE inhibitors. There is conflicting evidence regarding the need for aoic valve replacement in asymptomatic patients with severe aoic regurgitation. When aoic root dilatation is the cause of aoic regurgitation (e.g. Marfan's syndrome), aoic root replacement is usually necessary. <img alt="" src=" /> [/INST] question: Nocturnal anginal pain and severe disphoresis are seen in - | options: A: Acute severe MR B: Chronic severe MS with MR C: Acute severe AR D: Chronic servere AR | answer: D </s> |
<s>[INST] context: The average American child spends three to five hours a day watching TV. In 1961, the average child began to watch television at age three; however, today it is nine months. Yet, most parents think that television has bad influence on their children. For example, in the early 1970s, my parents believed that my bad eyesight was the result of sitting too close to the screen, and they therefore made my stay at least six feet from it. Today, most people have no such worry, but many new ridiculous sayings have appeared:
*TV makes kids stupid. Many children watch more educational programs when they are pre-schoolers. When they grow up, they can read more books and have much better ideas to solve difficult problems than other children.
*TV makes kids violent. The real story is not so simple. Hundreds of studies show that watching violence on TV makes children more aggressive . But a study of over 5,000 children also finds that some positive programs make children kinder. The problem is that kids are increasingly watching shows with violence instead of those suitable for their age.
*Sitting around watching TV makes kids overweight. An experiment finds that when children watch less television, they do lose extra weight; however, reducing their television time does not make them more active. The real problem lies in snacking . A widespread habit for kids, and junk-food advertisements.
*TV helps kids get to sleep. The opposite is true. The more television children watch, the more likely they are to have irregular sleep and nap patterns. Allowing kids to watch television is part of the problem, not the solution. [/INST] question: Which one is the advantage of educational TV programs? | options: A: They will make children solve difficult problems better than others B: they will improve children's ability to get along with others C: They are likely to make children more aggressive D: They will make sure of children's success in the future | answer: A </s> |
<s>[INST] context: Just as some people think that certain numbers are lucky or unlucky, others believe that we can use numbers to understand our personalities, or predict what will happen to us in the future.
Numerology is a way of using numbers to describe a person's character, and to make predictions about future life events. Numerologists use the numbers 1-9, 11 and 22 -- also known as the "master" numbers -- to help a person understand his or her personality, life goals, and destiny.
Numerologists consider yourLife Path number to be the most significant because this number describes your character. To find this number, add together all the numbers in your date of birth. For example, a person born on April 25, 1985 would add the month (4), to the numbers of the date (2+5), plus the numbers of the birth year (1+9+8+5). In this case the total is 34, so this person's life path number is 7(3+4). Numerologists believe that people with this number are peaceful and affectionate but can also be very reserved.
Your Expression numberdescribes your talents and predicts how you should use these to fulfill your destiny in life. Numerologists assign a number between 1 and 9 to each of the letters in your name. These numbers are then added together in the same way as before to find your Expression number. Numerologists can also do calculations to predict when the most challenging periods of your life will be.
Numerologists also believe that the day a person is born is important. Each day of the month has a character description. People born on the fourth are said to be responsible, honest, and stubborn. People born on the fifteenth have very strong attachments to family and home. Those who celebrate their birthday on the thirtieth are artistic, creative, and imaginative, and often make good writers.
If we calculate the numerical value of our name and birth date, numerologists believe that we can learn more about our personalities. They also believe that we can predict our destinies, how our lives will progress, and what challenges we may face along the way. To the numerologist, numbers can be used in many more ways than we think. [/INST] question: If a person was born on November 8, 1995, what is his Life Path number? | options: A: 7 B: 8 C: 9 D: 11 zxxk | answer: A </s> |
<s>[INST] context: Idiopathic scoliosis Risser's Localiser cast is used for non-operative correction of idiopathic scoliosis. Other casts and braces used for scoliosis are: Milwaukee brace, Boston brace Operative management of idiopathic scoliosis includes: The Harrington Rodding Rod and sublaminar wiring (Luque) The Cotrel-Dubousset system d.Anterior instrumentation (Dwyer; Zielke) Casts and Splints Minerva cast------------------------------------ Cervical spine fracture Hanging cast------------------------------------ Fracture Humerus Cylinder cast----------------------------------- Fracture Patella Patellar tendon bearing cast--------------- Fracture Tibia Aluminium splint----------------------------- immobilization of finger Thomas splint---------------------------------- Fracture femur Bohler Braun splint-------------------------- Fracture femur Toe rising splint------------------------------- Foot drop Knuckle bender splint----------------------- Ulnar nerve palsy Cock up splint--------------------------------- Radial nerve palsy Dennis Brown splint------------------------- CTEV Also Know Risser's sign: This is a sign to assess skeletal maturity as the scoliotic curvature progresses most during the period of rapid skeletal growth. The iliac apophyses sta ossifying sholy after pubey. Once the iliac crests are completely ossified, fuher progression of the scoliosis is minimal (Risser's sign) [/INST] question: Risser Localiser cast is used in the management of: | options: A: Kyphosis B: Spondylolysthesis C: Idiopathic scoliosis D: Lordosis | answer: C </s> |
<s>[INST] context: (Anti HBs Ag) (570-71-CMDT-08) (1933-34-H17th)Anti HBs antibody - appears in most individuals after clearance ofHBsAg and after successful vaccination against hepatitis B - signal recovery from HBV infection, non infectivity and immunity* HBe Ag indicates viral replication and infectivity** HBs Ag indicates the first evidence of infection* HBV DNA is more sensitive and precise marker of viral replication and infectivity*** IgG Anti HBc also appears during acute hepatitis B- But persists indefinitely* IgM anti HBc appears shortly after HBs Ag is detectedCommon serologic pattern in Hepatitis - B virus infection and their interpretationHBsAgAnti HBsAnti HBcHBe AgAnti HBeInterpretation+-IgM+-Acute hepatitis - B+-IgG+-Chronic hepatitis-B with Acute viral replication+-IgG-+Chronic hepatitis- B with low viral replication++IgG+ or-+ or -Chronic hepatitis -B with heterotypic anti HBs (About 10% (cases)--IgM+ or --Acute hepatitis -B-+IgG-+ or -Recovery from hepatitis-B (Immunity)-+---Vaccination (Immunity)**--IgG--False positive,less commonly infection in remote past [/INST] question: A nurse having vaccinated with hepatitis B (Not previous affect the hepatitis-B- infection).Which of the following found in blood examination. | options: A: HBsAg B: Anti HBs Ag C: AntiHBCAg D: Anti HBs Ag Anti HBC, core antigen | answer: B </s> |
<s>[INST] context: The original Olympics took place nearly 3000 years ago in the year 776 BC. Many different sports were played, including boxing, running, throwing the discuss , though there were fewer sports involved than those in the modern Olympics. The Games were held every five years until they were forbidden by the Romans in AD 393. The first new Olympics were held in 1896 in Greece. From 1900, the Games were held every four years, only three Olympics were wiped out because of wars---1916, 1940 and 1944.
Nowadays, different countries hold the Games in turns. The country which holds the Games provides vast facilities, including a stadium , swimming pools and accommodation , but competing countries pay their own players' expense.
The Olympics start with the arrival in the stadium of a torch , lighted on Mount Olympus by the sun's rays. The well-known Olympic flag, however, is a modern conception : the five interlocking rings symbolize the uniting of all five continents that take part in the Games. [/INST] question: When was the first new Olympics Games held? | options: A: In 776 BC B: In AD 394 C: In 1990 D: In 1896 | answer: D </s> |
<s>[INST] context: Prolonged labour Make it clear once and for all:? "Hematuria is not a feature of impending scar rupture". How would an impending scar produce hematuria??? Hentaturia indicates bladder involvement - In some cases of uterine rupture, bladder rupture can also occur. These cases of utrine rupture presents with hematuria. "So hematuria in a case of uterine rupture indicates that rupture has actually taken place, it is not impending". "Hematuria only occurs in uterine rupture when rupture has actually occurred and involved bladder too". A common cause of hematuria during labour is obstructed labour. "In obstructed labour the bladder becomes an abdominal organ and due to compression of urethra between the presenting pa and symphysis pubis, the patient .fails to empty the bladder. The transverse depression at the junction of the superior border of the bladder and the distended lower segment is often confused with the Bandls's ring. The bladder wall gets traumatized which may lead to blood stained urine, a common finding in obstructed labour". Clinical features of impending scar rupture: ? Tenderness over the site of uterine scar. Uterine contractions become tetanic. Signs of extreme fetal distress or death. Maternal tachycardia. Slight elevation in maternal temperature. [/INST] question: A pregnant women, previous LSCS with hematuria. Diagnosis is? | options: A: Impending scar rupture of uterus B: Prolonged labour C: Uretreral injury D: Cystitis | answer: B </s> |
<s>[INST] context: The sea is very big. When you look at the map of the world, you will find there is more water than land. The sea covers three quarters of the world. It looks very pretty when the sun is shining on it. It can be very rough when there is a big wind.
The sea is also very deep in some places. Some parts of the sea are very shallow. But in some places the depth of the sea is very great. There is one spot, near Japan, where the sea is nearly 11 kilometers deep! The highest mountain in the world is about 9 kilometers high. If that mountain were put into the sea at that place, there would be 2 kilometers of water above it!
The sea is salty. Rivers, which flow into the sea, carry salt from the land into the sea. Some parts of the sea are more salty than other parts. There is one sea, called the Dead Sea, which is very salty. It is so salty that swimmers can't sink! Fish can't live in the Dead Sea!
The sea can be very cold. Divers, who go deep down in the sea, know this. On the top the water may be warm. When the diver goes downwards, the sea becomes colder and colder. Another thing happens. When the diver goes deeper, the water above presses down on him. It squeezes him. Then the diver has to wear clothes made of metal. But he cannot go very deep. Some people who wanted to go very deep used a very strong diving ship! They went down to a depth of eleven kilometers. [/INST] question: When does the sea look beautiful? | options: A: When it is cloudy B: When it is a fine day C: When there is no wind D: When there is a storm | answer: B </s> |
<s>[INST] context: In 1933 an unknown American called Clarence Nash went to see the film-maker Walter Disney. He had an unusual voice and he wanted to work in Disney's cartoon film for children. When Walter Disney heard Nash's voice, he said, "Stop! That's our duck!"
The duck was the now-famous Donald Duck, who first appeared in 1934 in the film, The Wise Little Hen. Donald lived in an old houseboat and worn his sailor jacket and hat. Later that year he became a star after an eight minute Mickey Mouse film. The cinema audiences liked him because he was lazy and greedy, and because he lost his temper very easily. And they loved his voice when he became angry with Mickey's eight nephews. Soon Donald was more popular than Mickey Mouse himself, probably because he wasn't a goody-goody, like Mickey.
In the 1930s, 1940s, and 1950s, Donald and his friends Mickey, Goofy and Pluto made hundreds of Disney cartoons. He also made educational film about the place of the USA in the world, and safety in the home. Then in 1966 Donald Duck and his voice disappeared--there were no more new cartoons.
Clarence Nash died in February, 1985. But today's Children can still see the old cartoons on the television and hear that famous voice. [/INST] question: Who made Donald Duck cartoons? | options: A: Mickey Mouse B: Clarence Nash C: Walter Disney D: Pluto | answer: C </s> |
<s>[INST] context: Acute lymphoblastic leukemia, also known as acute lymphocytic leukemia or acute lymphoid leukemia (ALL), is an acute form of leukemia, or cancer of the white blood cells, characterized by the overproduction and accumulation of cancerous, immature white blood cells, known as lymphoblasts. In persons with ALL, lymphoblasts are overproduced in the bone marrow and continuously multiply, causing damage and death by inhibiting the production of normal cells (such as red and white blood cells and platelets) in the bone marrow and by spreading (infiltrating) to other organs. ALL is most common in childhood, with a peak incidence at 2-5 years of age and another peak in old age.The most common causes of splenomegaly in developed countries are infectious mononucleosis, splenic infiltration with cancer cells from a hematological malignancy and poal hypeension (most commonly secondary to liver disease, and Sarcoidosis). Splenomegaly may also come from bacterial infections, such as syphilis or an infection of the hea's inner lining (endocarditis)The causes of massive splenomegaly (spleen >1000 g) are fewer, and include: visceral leishmaniasis (kala-azar) chronic myelogenous leukemia myelofibrosis malaria splenic marginal zone lymphoma [/INST] question: Massive splenomegaly is not a feature of- | options: A: Acute lymphocytic leukemia B: Chronic myeloid leukemia C: Myelofibrosis with myeloid metaplasia D: Hairy cell leukemia | answer: A </s> |
<s>[INST] context: Studying abroad will shape you in various ways. You will learn things you never would have if you study overseas. But college is expensive in the United States. It's cheap or free in other countries even for foreigners, so why not get out of here and come back smarter?
More and more American students are currently studying at German colleges. That number has increased by 20% over the last three years. Living costs are about $7,000 a year, which is even lower than in other European countries and a great appeal to many students wanting to studying abroad. Besides, Germany encourages international students. They create a multicultural landscape that benefits German students as well. According to a new report, Germany is home to six of the world's 100 best universities. These schools offer around 900 degrees completely in English and many German students speak the language.
You could be part of Finland's excellent education system. The Finns charge no tuition and offer a number of courses purely in English. They would be happy for you to add flavor to their school scene. Cost of living there is high. Be prepared for frosty winters, but you will get that sweet midnight sun in the summer.
Many other European nations provide cheap or free college for foreign students, but if South America is more your thing, try Brazil. Most of the education will take place in Portuguese, so if that is in your plan you can study near beautiful beaches and jungles. The University of Sao Paulo and State University of Campinas are both highly ranked internationally. Your money will go a long way there, too.
Living on the economy in a foreign country will keep you on your toes. You will learn new customs, how to bargain, stay safe, budget and become more flexible with people. There is no better way to learn a language than by immersing yourself in it. What's more, you will become a more balanced person. New situations and challenges, from buying bread to traveling across town, will pop up daily. You will handle them and you'll make it by yourself. Before long, you will be ready for anything. Life in any part of the world will no longer surprise you. In your future career, this will be a benefit. International study on your resume will speak to your adaptability. [/INST] question: German universities are popular among US students mainly because . | options: A: they offer a multicultural landscape B: they belong to the world's best ones C: the students can get their degrees easily D: the cost of living there is affordable for them | answer: D </s> |
<s>[INST] context: A team is a group of people with a common goal. A school's football team has two goals. One goal is to win. That is what the team wants to do. The other goal is to build character. Character is what a person values, how a person gets along with others. That is why schools have football teams. They want to help students build good values.
Each team member builds character. They learn to cooperate . They learn to make good decisions. They work hard. They practice every day. They learn to follow the rules.
Each team member has a position . Each position is part of winning. No one player has the ability to win the game for the team. Only if the team works together does a team win. People often say, " _ "
Whether the team wins or loses, at the end of the game they congratulate the other team. That is called sportsmanship. While they fight to win during the game, it is just a game. They cannot be angry with the other team. If they are, they'll hear from their coach.
_ makes sure the team reaches the school's goal. The coach cares about the whole team. The coach gives each player advice. When the team wins, everyone celebrates. And the coach is glad. But after the season is over, the coach is still happy. The coach gets to see the players as they go to school every day. The character they have built is part of their success in school, too.[:Zxxk.Com]
Some coaches say that if you go into a classroom at their school you'll be able to tell the players. It is not that they are bigger than the other students. It is the ones who are helping other students work. Teamwork is part of their lives. [/INST] question: Schools build football teams mainly to help students _ . | options: A: get good grades B: become leaders C: build good values D: improve football skills | answer: C </s> |
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