Case 2S [symptoms] 10 month male presents to pediatrician’s offic.pdf

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Case 2 S [symptoms]: 10 month male presents to pediatrician’s office with chief complaint of fever and rash. In usual state of health until 4 days prior to presentation when developed fever, fussiness and decreased appetite. Mom thought maybe had thrush again because she noted some white spots in his mouth a day after the fever started but they went away on their own. Last night she noticed that his eyes started to appear more red and irritated, is now coughing and very congested and this morning developed rash on face prompting visit ROS [review of systems]: as above, no emesis, no constipation or diarrhea, +fewer wet diapers than usual PMHx [past medical history]: full term, uncomplicated pregnancy and delivery, neonatal jaundice but did not require phototherapy, thrush at 6 weeks and 3 months of age treated with nystatin SHx [social history]: lives with parents and 2 yo sibling who is enrolled in child care. Flew to California with family 3 weeks ago to visit grandparents, no other travel hx. Imm: UTD [up to date] Exam: T- 39.8 [temperature, C]; R -34 [respiratory rate]; P -120 [pulse]; BP-85/62 [blood pressure]; Pox-98% in room air [pulse oximetry, oxygenation of blood] Gen [general]: Alert, fussy infant on mom’s lap, crying with exam HEENT [head, eyes, ear, nose, throat]: Normocephalic/atraumatic, anterior fontanelle fibrous but flat, extraocular movements intact, pupils equal and reactive to light, +conjunctival erythema bilaterally without discharge or crusting, nares congested, oropharynx erythematous with sloughing of buccal and labial mucosa. Tympanic membranes erythematous but with intact landmarks and light reflex Neck: supple full range of motion, +1cm bilateral anterior cervical lymphadenopathy RESP [respiratory]: mildly tachypneic with fair air exchange all fields, +subcostal retractions no intracostal or suprasternal accessory muscle use, diffuse crackles audible on auscultation all lung fields no wheezing or rhonchi COR [cardiac]: tachycardic, regular, nl s1 and split s2, no murmurs, rubs or gallops Abdomen: soft, normoactive bowel sounds, nontender non distended, no hepatosplenomegaly, no masses GU [genital/urinary]: circumcised tanner I male, no rashes Skin: diffuse erythematous blanching maculopapular rash most prominent/confluent on face, neck, and upper trunk, palms and soles spared, no desquamation Extremities: warm and well perfused a) What were the spots in the infant’s mouth that the mother mistook for thrush? b) What is your diagnosis, and which symptoms lead you to this conclusion? c) Which tests will you order to confirm this diagnosis (give the name and state what is being measured)? d) The patient is up to date on his vaccinations, so why was he susceptible to this disease? Where did he likely contract the disease? e) In an uncomplicated form, this condition is not usually fatal, but what can cause fatalities for patients with this infection? f) A similar patient might be admitted to the hospital or might not fo.

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b) What is your diagnosis, and which symptoms lead you to this conclusion?
c) Which tests will you order to confirm this diagnosis (give the name and state what is being
measured)?
d) The patient is up to date on his vaccinations, so why was he susceptible to this disease? Where
did he likely contract the disease?
e) In an uncomplicated form, this condition is not usually fatal, but what can cause fatalities for
patients with this infection?
f) A similar patient might be admitted to the hospital or might not for this condition (depending
both on the physician’s judgments and specific details of the patient’s presentation). Give several
reasons why you might NOT admit this patient, and several reasons why you MIGHT (your
reasons might not pertain to this exact patient).
g) IF the patient is admitted to the hospital, the patient will stay in a room with negative air
pressure, and all staff interacting with the patient will need to wear N95 respirators. Why are
these precautions necessary?
Solution
a) The spots in the infant's mouth may be due to Strep throat. I mean the mother mistook them
for fungal infection; but may be it is a bacterial infection.
b) Maculopapular rash on the skin led to this conclusion. This type of rashes appear in bacterial
infection; they occur when beta-lactam antibiotic is given. The child had visited California 3
weeks back; may be he develped infection that time.

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is an upper respiratory tract bacterial infection associated with a characteristic rash, which is caused by an infection with pyrogenic exotoxin (erythrogenic toxin) -producing GAS in individuals who do not have antitoxin antibodies In the past. scarlet fever was thought to reflect infection of an individual lacking toxin-specific immunity with a toxin-producing strain of GAS. Subsequent studies have suggested that development of the scarlet fever rash may reflect a hypersensitivity reaction requiring prior exposure to the toxin.

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Financial & Managerial Accounting Assignment 1 – Financial Statement Analysis Financial & Managerial Accounting Assignment 1 – Financial Statement Analysis Guidelines for assignment This is an individual assignment Ground your answer in relevant theory Plagiarism and reproduction of someone else’s work as your own will be penalized Make use of references, where appropriate – Use Harvard or APA referencing method. Late submission are not accepted Financial & Managerial Accounting Assignment 1 – Financial Statement Analysis Structural elements should include an introduction, main body, and a conclusion Weight – 50% Word count guidance : part 1 – N/A. Business report wordage should be 2000 +/-10% Type of assignment: Excel Assessed Work Folder and Business Report Start / Finish : Week 3 – 4 Learning Outcome Assessed: 1,2,3,4 Submit one single document and not lots of different files. Comprehensive SOAP Exemplar Purpose: To demonstrate what each section of the SOAP Note should include. Remember that nurse practitioners treat patients in a holistic manner, and your SOAP Note should reflect that premise. Patient Initials: _______ Age: _______ Gender: _______ SUBJECTIVE DATA: Chief Complaint (CC): Coughing up phlegm and fever History of Present Illness (HPI): Sara Jones is a 65-year-old Caucasian female who presents today with a productive cough x 3 weeks and fever for the last 3 days. She reported that the “cold feels like it is descending into her chest.” The cough is nagging and productive. She brought in a few paper towels with expectorated phlegm – yellow/brown in color. She has associated symptoms of dyspnea of exertion and fever. Her Tmax was reported to be 102.4 last night. She has been taking Ibuprofen 400mg about every 6 hours and the fever breaks, but it returns after the medication wears off. She rated the severity of her symptom discomfort at 4/10. Medications: 1.) Lisinopril 10mg daily 2.) Combivent 2 puffs every 6 hours as needed 3.) Serovent daily 4.) Salmeterol daily 5.) Over-the-counter Ibuprofen 200mg -2 PO as needed 6.) Over-the-counter Benefiber 7.) Flonase 1 spray each night as needed for allergic rhinitis symptoms Allergies: Sulfa drugs - rash Past Medical History (PMH): 1.) Emphysema with recent exacerbation 1 month ago – deferred admission – RX’d with outpatient antibiotics and hand held nebulizer treatments. 2.) Hypertension – well controlled 3.) Gastroesophageal reflux (GERD) – quiet, on no medication 4.) Osteopenia 5.) Allergic rhinitis Past Surgical History (PSH): 1.) Cholecystectomy 1994 2.) Total abdominal hysterectomy (TAH) 1998 Sexual/Reproductive History: Heterosexual G1P1A0 Non-menstruating – TAH 1998 Personal/Social History: She has smoked 2 packs of cigarettes daily x 30 years; denied ETOH or illicit drug use. Immunization History: Her immunizations are up to date. She received the influenza vaccine last November ...

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Comprehensive SOAP Exemplar Purpose: To demonstrate what each section of the SOAP note should include. Remember that Nurse Practitioners treat patients in a holistic manner and your SOAP note should reflect that premise. Patient Initials: _______ Age: _______ Gender: _______ SUBJECTIVE DATA: Chief Complaint (CC): Coughing up phlegm and fever History of Present Illness (HPI): Sara Jones is a 65 year old Caucasian female who presents today with a productive cough x 3 weeks and fever for the last three days. She reported that the “cold feels like it is descending into her chest”. The cough is nagging and productive. She brought in a few paper towels with expectorated phlegm – yellow/brown in color. She has associated symptoms of dyspnea of exertion and fever. Her Tmax was reported to be 102.4, last night. She has been taking Ibuprofen 400mg about every 6 hours and the fever breaks, but returns after the medication wears off. She rated the severity of her symptom discomfort at 4/10. Medications: 1.) Lisinopril 10mg daily 2.) Combivent 2 puffs every 6 hours as needed 3.) Serovent daily 4.) Salmeterol daily 5.) Over the counter Ibuprofen 200mg -2 PO as needed 6.) Over the counter Benefiber 7.) Flonase 1 spray each night as needed for allergic rhinitis symptoms Allergies: Sulfa drugs - rash Past Medical History (PMH): 1.) Emphysema with recent exacerbation 1 month ago – deferred admission – RX’d with outpatient antibiotics and an hand held nebulizer treatments. 2.) Hypertension – well controlled 3.) Gastroesophageal reflux (GERD) – quiet on no medication 4.) Osteopenia 5.) Allergic rhinitis Past Surgical History (PSH): 1.) Cholecystectomy 1994 2.) Total abdominal hysterectomy (TAH) 1998 Sexual/Reproductive History: Heterosexual G1P1A0 Non-menstrating – TAH 1998 Personal/Social History: She has smoked 2 packs of cigarettes daily x 30 years; denied ETOH or illicit drug use. Immunization History: Her immunizations are up to date. She received the influenza vaccine last November and the Pneumococcal vaccine at the same time. Significant Family History: Two brothers – one with diabetes, dx at age 65 and the other with prostate CA, dx at age 62. She has 1 daughter, in her 50’s, healthy, living in nearby neighborhood. Lifestyle: She is a retired; widowed x 8 years; lives in the city, moderate crime area, with good public transportation. She college graduate, owns her home and receives a pension of $50,000 annually – financially stable. She has a primary care nurse practitioner provider and goes for annual and routine care twice annually and as needed for episodic care. She has medical insurance but often asks for drug samples for cost savings. She has a healthy diet and eating pattern. There are resources and community groups in her area at the senior center and she attends regularly. She enjoys bingo. She has a good support system composed of family and friends. Review of Systems: General: + fatigue since the illness starte ...

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Is the mean age at which American children learn to walk less than 15.pdf

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Introduction to material science What kind of analyses methods will you take to examine the lattice constants surface morphology with 1-10 mu m dislocation preferred orientation? Solution a) For lattice constant X-ray diffraction (XRD) is the best technique to analyse. The atomic planes of a crystal cause an incident beam of X-rays to interfere with one another as they leave the crystal. This phenomenon is known as X-ray diffraction. X-ray diffraction has been in use in two main areas, for the fingerprint characterization of crystalline materials and determination of their structure. Each crystalline solid has its unique characteristic X-ray powder pattern which may be used as a “fingerprint” for its identification. b) For surface morphology Scanning electron microscopy (SEM) is the best technique to analyse. Scanning electron microscope is an instrument where entire primary electron beams emitted from an electron source are scanned on sample and a scanning image is obtained from a detection signal produced by secondary particles generated from the sample. Scanning electron microscope actually capable of obtaining a scanning image with high spatial resolution within a low acceleration voltage region c) For dislocation Weak-Beam Dark-Field is the best methdo to analyse. d)For orientation Geiger counter xray spectrometer is the best device to use..

Introduction to material science What kind of analyses methods will .pdf

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Is this a Cohort Study? What would be an example of a Cohort study? 1) Solution Cohort studies, case control studies and randomized controlled trials When people read about a research study, they may not pay attention to how the study was designed. But to understand the quality of the findings, it\'s important to know a bit about study design. According to the widely-accepted hierarchy of evidence, the most reliable evidence comes from systematic reviews (see Infocus, Summer 2004), followed by evidence from randomized controlled clinical trials, cohort studies and then case control studies. Research studies typically fall into one of two main categories: Observational studies Here researchers observe the effect of a risk factor, diagnostic test or treatment without trying to influence what happens. Such studies are usually \"retrospective\".

Is this a Cohort Study What would be an example of a Cohort study.pdf

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Function of medium veins Function of medium veinsSolution.pdf

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Explain the four factors of production. In what way are they related to the circular flow diagram? Explain the four factors of production. In what way are they related to the circular flow diagram? Solution The four factors of production are land, labor, capital and entrepreneurship. These factors are used in almost every firm to produce a commodity. The returns to these factors are rent, wages, interest and profits respectively. The land, capital, labor and entrepreneurial services are the factor inputs by the households to a firm. The households in turn gets rent, interest, wages and profits respectively from the firm..

Explain the four factors of production. In what way are they rela.pdf

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Discrete Math problem: 37 students use a variety of forms of transportation to get to school everyday. 20 of them sometimes arrive to school by car;12 students bike to school at least occasionally;16 students take the bus somedays. If four students use all three of these options,two either bike or take the bus,six come by car or bike,and five arrive by car when they do not come on the bus,how many students always use some other type of transportation? Solution.

Discrete Math problem37 students use a variety of forms of transp.pdf

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Discuss the involvement of interest groups in the political circumstances that affect \"agenda setting.\" You should incorporate the specific ways they influence agenda setting in your response. Solution Agenda setting is the ability to influence the importance of topics on public agenda. The involvement of interest groups in the political circumstances that affect \"agenda setting\", gives more depth and gravity to the process. It makes the process more relevant and germane. Most importnatly, it gives the matter a practical feel and a tangible feel. The agenda becomes identifiable due to the involvement of interest groups. For example people in India are demanding one rank one pension (OROP) for army and defense personnels, on the same lines as civic officials. The involvement of retired defense personnel (interest groups) has given the process a more relevant outlook. More political parties are involved now. The ways in which the agenda setting can be done are: first level agenda setting - here the importnace is given to the issue on hand. The next level or the second level of agenda setting gives importance to the attributes of the agenda. This level considers how opinion are affected by the agenda..

Discuss the involvement of interest groups in the political circumst.pdf

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Determine which of these statements describing the cytochrome P450 family of enzymes or the mechanism of action are true. a) The iron in cytochrome P450s can exist in both Fe2 and Fe3 states in a single catalytic cycle. b) The coenzyme NADPH can serve as a source of electrons for cytochrome P450s. c) Fe3 acts as a general base during the catalytic cycle. d) Each cytochrome P450 isoform can act on only one specific organic substrate. e) Cytochrome P450 uses molecular oxygen (O2) as a reactant. f) The activity of cytochrome P450 generally results in carboxylated products. Please include an explanation with your answer! Thank you. Solution Cytochrome P450 is a class of enzymes essential for many metabolic reactions. This includes about 50 enzymes. ‘Heme’ is the cofactor of all these enzymes, means ‘heme’ is present in the active site of the enzyme. ‘Heme’ shifts from Ferrous and ferric states as electrons are accepted and donated. So, statement (a) is totally correct. And this iron component is present in the centre of porphyrin ring. So, single/same catalytic site is there for ferrous and ferric. In mitochondria, electrons are transferred from NADPH by cytochrome P450 reductase. So, statement (b) is correct. Base is anything which accepts protons. Fe3 (ferric) accepts protons from oxygen in mitochondria. So, statement (c) is also correct. Statement (d) is incorrect. There are several isoforms of P450. Among these CYP3A4 is the most important. It metabolizes nearly half of the total drugs used in clinical biology nowadays. These include codeine, acetaminophen, erythromycin etc. So, one isoform would act on many organic substrates. Statement (e) is correct. Yes, it uses molecular oxygen, and converts it to water. Statement (f) is incorrect. Activity of cytochrome P450 resulted in formation of water (by reduction of oxygen); this is not a carboxylated product..

Determine which of these statements describing the cytochrome P450 f.pdf

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Describe the difference between the lytic cycle and lysogeny when bac.pdf

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Describe some of the different ways members of Congress can represent the American people. What are the principles behind sociological and agency representation? What are some examples of each type? Describe the difference between a trustee and a delegate. Which type of representation do you believe is the best? Describe the electoral connection in Congress. Describe some examples of constituency service. What are some of the ways a member of Congress can directly aid their state or district? What effect do incumbency and redistricting have in the makeup of Congress? Solution Congress is the most important representative institution in american government. It is the voice of the american people. Members of congress consider different views and demands as they reprsents their district. Member of congress regularly reach out to their constituents and devote a great amount of staff amount to constituency service . teh farmers of the constitution provided for bicameral legislature with House and Senate to serve different constituencies . They are Law and Policy makers and on the other hand represent the needs and the best interest of their particular constituents. The Snete is choosen by the state legislatures and serve a total six year term represents the elite member of society . While the house who are elected by voters in congressional districts serves a two year term represent the people or well organized local interests. Sociological representation is a type of representation in which representative have similar racial , ethnic , religious or educational background as their constituents . Sociological likeness helps promote good represntation by the government . On the other hand agency representation act as an agent of his or her constituency. Constituent hire their agency representative and if the constituent feel they are not being represnted well they can fire their representative . There are two different ways elected legistators in congress can act. One way is to act as a trustee . this mean that the legistators will vote and act according to their own personal belief and what they feel is best for society Unlike the trustee a delegate vote according to whom they represents . The deligate connects to their constituents completely tries hard to epathize with their feelings and wants to be liked by the constituents ..

Describe some of the different ways members of Congress can represen.pdf

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Company B Company C None of them satisfy the requirements. Question9 The 3-way switch on the Board of Education board should be set to position positionwhen downloading your code. making modifications to your breadboard and 0 cut of 5 points Selected Answer: 1,o Answers 0, 1 1,0 0, 2 1, 2 Solution Position 0 (left): is to power OFF while making modifications (adding or changing components). Position 1 (middle): while LOADING the program. Position 2 (right): when you\'re READY for the robot to start moving. So, Answer is 0, 1..

Company B Company C None of them satisfy the requirements. Question9 .pdf

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A Correlation of zero means that (what)SolutionA value of zer.pdf

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A bank had 5024 depositers, with an avevrage account of $512. Assume the standard deviation is $150. Find the mean and standard deviation of the sampling distribution of the average balance for a random sampling of 1000 depositors. (Finite population corrector needed) Solution mean and standard deviation of the sampling distribution Mean = 512 Standard deviation = s.d/Sqrt(n) = 150/Sqrt(1000) = 4.7434.

A bank had 5024 depositers, with an avevrage account of $512. Assume.pdf

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You cut your finger, and your skin cells divide to heal up the wound. What type of nuclear division is happening in the skin cells? (Mitosis or meiosis?) and why. You cut your finger, and your skin cells divide to heal up the wound. What type of nuclear division is happening in the skin cells? (Mitosis or meiosis?) and why. Solution When we cut our finger the skin cells undergo mitotic division to heal up the wound, because skin is a somatic cell not a germ cell. Only germ cells like egg cell and sperm cells undergo meiosis as these cells are the only haploid and give rise to a new organism with n+n = 2n number of chromosomes. In our body rest all cells divide by mitosis, as mitosis ensures that (2n)chromosomes after dividing are distributed evenly between two cells and maintain the idenity of the cell while dividing..

You cut your finger, and your skin cells divide to heal up the wou.pdf

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