Effect of Shot Peening on the Microstructure and Mechanical Properties Essay

Impact of Shot Peening on the Microstructure and Mechanical Properties - Essay Example The resulting writing based comprehension can empower dismembering further into this field with the end goal of future turns of events, research and studies. Added substance Manufacturing (AM) is a technique through which the different segments are joint together for the huge motivation behind making a substance identified with the 3D model informational index, normally layered one over the other, rather than different strategies, for example, that of the subtractive assembling philosophy [1-5]. This specific strategy is accepted to achieve the new strategies and procedures which will for the most part make the general procedure of basic structure and creating significantly more effectively when contrasted with the already existing techniques and methods. With the given current headways and improvements as robotization upheld highlights, without the apparatus strategy or AM bolstered working units, each will profit by the given technique and new procedures consolidated in such manner [6]. A normally utilized and executed technique in such manner is that of the AM bolster unit as Direct Metal Laser Sintering, which joins the component capa city of producing a net-organized part and can additionally stretched out for the whole procedure of assembling using the pre-alloyed powders [7-10]. Parts that are created through this technique yield increasingly exact outcomes and the made viewpoint is significantly more valued and energized as far as quality and general standpoint. [10]. Consequently, shot peening is conceivably a choice towards utilizing the methods that empower planning any structure and any viewpoint based article.

E-business and e-commerce web applications Essay

Distinguish e-business and web based business web applications to help the proposed usage First off internet business is perhaps the best thing for business whether you have your entire business through the web or incompletely. On the off chance that you have a physical store, you are constrained by the zone that you can sell your item or offer assistance. An internet business site starts your business to the world. Notwithstanding these two drivers,online retail is likewise determined by traffic from web crawlers. One of the most significant positives of web based business is the brought down expense. A piece of these brought down expenses could be given to clients as limited costs. Promoting and showcasing is worldwide and you improve purchasing market. For work force utilize the robotization of checkout, charging, installments, stock administration, and other operational procedures, brings down the quantity of representatives required to run a web based business arrangement. To wrap things up Real domain, the store needn't bother with a conspicuous physical area. you can Locate the Product Quicker, dispose of movement time and cost, give examination shopping, likewise cross reference bargains, deals, coupons, and gathering buying.if you do open an e-business vulnerabilities that should be considered on the off chance that you choose to make an internet business website is security inner and outer. Programmers endeavoring to take client data or upset the site or server containing client data that is taken. Additionally Imposters can reflect your web based business webpage to take customer’s cash. approved heads/clients of a web based business site downloading concealed dynamic substance need to watch the assaults on web based business framework. Sweeps ought to be much of the time done on your server. this will help recognize any noxious projects that might be running worms, infections or Trojan ponies. Restricted client access will guarantee that you know precisely who approaches your internet business framework and allot every client with extraordinary access confirmation strategy.

Lake Effect Snow Research Paper Example | Topics and Well Written Essays - 750 words

Lake Effect Snow - Research Paper Example Lake snow impact as a rule occurs throughout the winter and specifically the Midwest when the region is commanded by cold cP or cA and clear air (Ahrens 207). The particular zones where the lake impact snows are infamous are the eastern and southern shores of the Great Lakes (Geerts 1). At the point when such a wonder happens, the individuals in this locale get readied for overwhelming snow showers. These tempests are profoundly limited and they stretch out just a couple of kilometers to progressively a hundred kilometers inland. The snow fundamentally falls as gust or substantial shower in the concentrated zones. The snow is a lot of unified with the end goal that a piece of the city may collect a few centimeters of the day off, in another; the ground has nothing (Ahrens 207). Lake impact snow is widespread from the long stretch of November to January. â€Å"During these months, cold air moves over the lakes when they are generally warm and not exactly frozen† (Ahrens 207). The distinction among air and water temperature can be as high as 25 degrees centigrade. Studies directed have shown the more prominent the distinction in the temperature, the higher the likelihood of having a snow shower. Reasons for Lake impact Snow Note that the snowfall isn't brought about by the nearness of the sea or the mountains and the thing that matters isn't on the grounds that the eastern and the southern shores are cooler than the locales environmental factors; truth be told, they are just somewhat hotter than the encompassing shores.

The Significance of the Beginning Chapter of Frank McCourts Angelas Ashes :: Essays Papers

The Significance of the Beginning Chapter of Frank McCourts Angelas Ashes He is simply one more poor Irish kid. His story is of destitution, passionate battles, and growing up. Have we not found out about that as of now? Everybody thinks their adolescence is special, however do we not all have essentially similar encounters? Candid McCourt encounters occasions like other youngsters, however that reality is overlooked once the peruser starts Angela’s Ashes. Genuine reality turns out to be less significant than this little boy’s impression of the real world, whereupon the center is set and stays there all through the book. McCourt isn't recounting to the narrative of what occurred, but instead of how the occasions identified with his own turn of events. He attracts the peruser into himself by composing the principal individual and utilizing an individual tone which consistently mirrors his viewpoint. In the primary part, he unnoticeably sets up himself as the main character in his diary, causing the peruser not to finish him his youth, yet to b ecome him as a kid. â€Å"People wherever boast and whine about the troubles of their initial years, however nothing can contrast and the Irish version†(1), McCourt composes as he portrays the world wherein he grows up. For he makes a different world for himself, where individuals he knows meander in and out at whatever point they can hold his consideration. McCourt’s world fills in as a way of dealing with stress just as an outflow of his inventiveness. He encircle himself with the discouraging truth about his home and family, yet gets every piece of truth with his own clarification, regularly hilarious, in this way presenting himself just to his translation of the real world. McCourt’s task is to contain his reality in the 400 sixty pages of the book and to have the peruser submerged before the finish of the main part. The initial pages give an establishment to McCourt, himself, and for his observation, empowering the peruser to follow his continuous flow sentences all through the book. He gives a blaze see of the book’s content on the principal page, giving the peruser a thought of what he is getting into. McCourt then suddenly interferes with himself (which gets basic all through the book) just as he has neglected to make reference to some appropriate actuality, and afterward continues to present his folks. In spite of the fact that he is currently composing from his parents’ perspective, the peruser is very mindful this is still McCourt’s translation of their story.

The Impact of Peer Pressure in Adolescents and How to Cope with It - Free Essay Example

Psychology is the scientific study of the human mind and its functions, especially those whose behavior is affected in their given circumstance. It basically focuses on the mental or behavioral characteristics of an individual or group. In other words, psychology analyzes the mind and behavior of individuals and groups and it plays a role in how people react or interpret a particular field of information or activity. In essence, psychology is used to analyze and explain important matters in the mental and behavior state of mind of the lives of people, communities, and the world. In every society, there’s many public issues that needs to be address and how we go about them is what makes a difference. The purpose of this research paper is to understand how peer pressure and other related issues affect people like children, adolescents and how it associates with their academic endeavors and stress. Peer pressure is something that can affect people in many ways and can even bring them down to a negative state of mind. That is why it is important for people to be able to manage stress and know different methods on how to deal with it and go about it despite facing social pressures. It can range from the type of personality an individual has and how it can play a role in their daily lives. According to chapter eight from the book by Branscombe and Baron, Social Psychology, it states that, â€Å"In more contemporary times, personality has come to mean a conglomeration of several characteristics – behaviors, expressions, moods and feelings – that are perceived by others. The complexity of one’s personality is thought to be shaped by genetic factors, family dynamics, social influences, and a wealth of personal experiences† (Branscombe and Baron, pg. 261). Meaning, the way individuals’ personalities are shaped is based on a number of factors such as one’s biological nature, family makeup, social elements, and past experiences. This can affect an individual’s personality in terms of how they react to their genetic makeup, household influence, social standards and past experiences. According to chapter 10 from the book by Branscombe and Baron, Social Psychology, it states` that, Provocation is one of the elements in â€Å"The Role of Emotions in Aggression†. For instance, someone having a bad day due to the fact their marriage ended, can be in an aggressive state of mind at work, if they fail to control their emotions. However, if that individual is able to control his emotions, he would be functional at work and no one would be able to tell he or she is going through a divorce. It is important for people to be able to control their emotions as there is a time and place for them and allowing them to take over can bring consequences to people (Branscmbe and Baron pg332-33). Another interesting fact mentioned in the chapter is that, â€Å"Many health-related problems are thought to be directly tied to our inability to recognize and appropriately express our emotions. Meaning, as humans it is natural for us to experience stress but how we interpret it, is what determines how we would go about it when expressing it. For example, a student stressing a final exam can feel anger, which would probably cause him to take his anger out on his instructor as a form of outlet due to the stress their feeling. Or fear, which would most likely cause him to miss class the day of the exam in order to avoid facing the exam. Anger and fear are known to be two sides of the â€Å"same coin† and are emotions that caused by a stimuli apparent to be a danger at a physical, mental, emotional, or spiritual level, or possibly a mix of these. Both of these emotions are associated with stress response and its important for people to be mindful of them in order to add to thei r stress or placing themselves into an inconvenient circumstance. People who can’t control their emotions or ventilate it correctly are categorized as one of the following: somatizer, self-punisher, exploder, or under handler. These emotions happen to be survival emotions, as it connects to Darwin’s theory of survival of the fittest. Anger results to fighting in order to â€Å"survive† and fear triggers the â€Å"flight response†. When individuals go through stress it isnt something that happens to people during bad times only, but can occur during good times as well. For example, a high school student that is anticipating graduation but is fearful they may not meet the requirements. However, once confirmed they are graduating, they can be overjoyed to the point that the stress hormone oxytocin in their brain can take effect. Based on chapter six from the book Managing Stress: Principles and Strategies for Health and Well-Being, by Brian Luke Seaward it states that, â€Å" there is another emotion associated with stress: joy and happiness, also known in stress circles as eustress. The emerging field of positive psychology has placed joy and happiness as a big X on the psychological treasure map† (Seaward, pg. 141). Meaning, stress isnt only composed of anger and fear. Joy and happiness is viewed as the positive aspects of stress and are better identified as eustress. â€Å"†¦ the pursuit of happin ess is a hot commodity in the age of twenty-first century stress† (Seaward, pg. 141). The rise of positive psychology has placed a lot of emphasis on joy and happiness in order for individuals to obtain an emotional balance in their life. Based on a journal article called, â€Å"Mindfulness, Quality of Life, and Severity of Depressive Symptoms Among Patients with Schizophrenia and Patients with Major Depressive Disorder† by Rayan and Ahmad Hussein Rateb, it provides a definition for mindfulness. It states that, â€Å"Mindfulness is defined as paying attention in a nonjudgmental manner to ones emotions, thoughts, and bodily sensations in the present moment, with maintaining a moment-by-moment awareness and acceptance of what is going on in the surrounding environment†¦Ã¢â‚¬  (Rayan A. H. R., 2017). This quote from the article defines someone who is in control of their emotions and unaffected by inside forces, while at the same time, they are behavior is not affected by outside forces. They instead observe the situation and act accordingly as they are expected to, despite their personal emotions towards the circumstance. â€Å"The non-judgmental acceptance of a stressful situation decreases stress by ena bling observation of negative thoughts and emotions that emerge during the situation without engagement with these thoughts and emotion a simple mindfulness of breath exercise may involve sitting in a chair or on the ground, practicing deep breathing, nonjudgmentally observing body sensations in the present moment, and redirecting attention back to the present moment when distraction occurs†¦Ã¢â‚¬  (Rayan A. H. R., 2017). It is evident that accepting the circumstance that causes one’s stress decreases as one is embracing the situation by acknowledging it. This enables individuals to do exercises such as practicing deep breathing or counting until a specific number can reduce stress and allow individuals dealing with the situation to act accordingly. Based on chapter six from the book Managing Stress: Principles and Strategies for Health and Well-Being, by Brian Luke Seaward, depression is defined as, â€Å"A state of mind where thoughts are clouded by feelings of despair. Physiologists suggest that depression is caused by a chemical imbalance; psychologists suggest that depression is the result of unresolved stress emotions (Anger turned inward)† (Seaward, pg. 140). In other words, depression occurs when individuals are overwhelmed and affected either within themselves or by outside factors negatively. Meaning, they can have low-self-esteem, question their self-worth, and insecurities overwhelm their mind. Many social factors that occur in our society impacts individual’s emotions in many ways. Adolescents in particular, are seen going through a lot of stress and studies show how it contributes to their academic performance. These social issues are forms of stress factors that hinders adolescents and childrenâ€⠄¢s performance in school in many ways. One social issue is the obesity rate that is occurring within the United States, which can play a negative role in the lives of children and adolescents in many ways and add to their stress. Based on â€Å"Longer Exposure to Obesity, Slimmer Chance of College? Body Weight Trajectories, Non-Cognitive Skills, and College Completion†, it states that, â€Å"While one of these studies investigated how different weight trajectories are linked to health outcomes in adulthood†¦ no weight trajectory research has examined the impact of adolescent weight development on the likelihood of finishing college education.† (Cheng, 2014).   This shows basically how children going into adolescence stress can affect their academics in terms of moving forward based on their weight. In other words, weight can play an indicator whether or not a child whos entering adolescence can have the potential to graduate and attend college. For example, a child’s self-esteem can be low and can cause them to shy away from completing their studies based on how they feel society perceives them in a negative way due to their obesity. Another interesting point depicted in the journal is that, â€Å"Most research adopts a gender lens when investigating consequences of obesity, since the social consequences of excessive weight tend to be more negative for women than for men†¦Ã¢â‚¬  (Cheng, 2014). It is important for people to understand that when it comes to getting statistical information, gender does play a factor in the outcome. For instance, women tend to be affected in a more negative matter when it comes to weight than men do. Weight issues can be more impacting on women since they are the ones who go through big changes such as when they get pregnant or have a lot of hormones that can affect their eating habits as well as their metabolism overall. Bullying is also a factor that contributes to the stress in students’ in relation to the completion of their education. Based on the article, â€Å"Adolescents’ Perspectives of Youth Non-Suicidal Self-Injury Prevention† by Emily Berger, Penelope Hasking and Graham Martin, it states that, â€Å"Although equally prevalent in males and females (Muehlenkamp Gutierrez, 2004), males are more likely to hit themselves and females are more likely to cut themselves (Whitlock, Eckenrode, Silverman, 2006). Primarily used to manage intense emotions, NSSI is associated with adverse events (e.g., bullying, childhood abuse; Nock, 2009), and those who engage in NSSI are at elevated suicide risk†¦Ã¢â‚¬  (Berger, Hasking Martin, 2017). Due to factors like bullying or traumatic experiences, males and females manage intense emotions differently. Males have the tendency to hit themselves, while women cut themselves physically. There are situations where both males and females resulted to these extremes due to the bullying or childhood abuse they had experienced in the past. In most cases, it occurs due to a child’s or adolescent’s weight or physical appearance. The article also pointed out that, â€Å"Increasing awareness of potential negative consequences may be particularly helpful when educating adolescents† (Berger, Hasking Martin, 2017). This quote puts emphasis on the concept of raising awareness overall because it can end up helping adolescents on how to cope with their issues and ultimately prevent them from harming themselves physically. It is evident that individuals need to be mindful of other people’s feelings because it can lead them to give up on their dreams, educative endeavors, or far worse, their own life. Students who drop out of school don’t all necessarily drop out on their own will but probably based on their circumstance and emotional state of mind. According to â€Å"Routes and Reasons Out, Paths Back: The Influence of Push and Pull Reasons for Leaving School on Students’ School Reengagement†, it mentions that, â€Å"The fact that students drop out of high school for different reasons has been understood for decades (Cairns, Cairns, Neckerman, 1989; Combs Cooley, 1968; Gambetta, 1987; Hill, 1979; Wehlage Rutter, 1986). Often this work highlights one reason, for instance, pregnancy, employment, or school connections (Carter, 2005; Mihalic Elliott, 1997; Upchurch McCarthy, 1990). Grouping the reasons for dropping out into either school factors that push a student out of school, or individual factors that pull a student out of school is a relatively new way of conceptualizing the process of dropout†¦Ã¢â‚¬  (Boylan Renzulli, 2017). Based on these fac ts, it is quite clear that some students drop in fear of how they might be viewed by their peers, or due to circumstances where they go through some drastic changes or experiences like pregnancy or bullying. Not enough emphasis is put on the concept of bullying as it is basically a way of harassing and discriminating someone based on their looks, or who they are. The article also states that, â€Å"If a student who once dropped out returns to complete their secondary education, such negative effects may be ameliorated† (Boylan Renzulli, 2017). This means that it is actually quite difficult for adolescents and people in general to go back to school and complete their education. This may be due to them feeling â€Å"too old† or a sense of â€Å"rejection† from the school atmosphere as well as the problems going on in their own personal life. According to the article, â€Å"The Gendered Monitoring of Juvenile Delinquents: A Test of Power-Control Theory Using a Retrospective Cohort Study† by Corina Schulze and Valerie Bryan, they state that, â€Å"†¦ a troubling array of family conflict was identified in the youths’ files. The presence of any abuse was identified for 184 youth, 62 girls and 122 boys. For girls, abuse was mentioned in the files in exactly 50% (31) of the cases, and about 24% (29) of the boys’ cases. Nineteen of 45 youth both had abuse identified in their files and their custody was disrupted. Seventeen girls and 8 boys were identified as sexual abuse victims† (Schulze Bryan, 2017). The statistics provided show that adolescents who turned out to be delinquents experienced some form of abuse or had some type of family conflict and shows how their anger contributed to worsening their circumstance. This evidently, could mean that based on those experiences, these adolescentsâ⠂¬â„¢ character are shaped in an emotional imbalanced, negative and painful way which lead them to a wrong path away from their educational goals. For instance, a single parent can play a negative role in the lives of their children as well as their own in many ways. Their economic status or the absence of the other parent can affect their children psychologically and socially overall. There’s a lot of emphasis put on the fact that single parents under the age of 18 percentage has increased from about 7% in 1950 to about 30% in 2010. This helps explain and understand why most single parent families’ fall below the poverty line because it is more difficult to pursue a higher education to get a good job based on the lack of economic resources they do not have. The recent article mentioned also noted that, â€Å"Juveniles are not just rebelling against parental authority; they are reacting against external controls as well† (Schulze Bryan, 2017). This justifies the behavior some adolescents normally have, but in a juvenile’s case, they tend to try to break away from rules that regulate them and believe they have â€Å"grown up†. When this occurs, they may stop cooperating with societal demands that allows them to progress and grow. In some cases because of their illegal actions, they are forced out of school or end up dropping out before completing high school. When a child does not have the environment, economical resources, and family make up, they are more vulnerable to grow up misguided and hit a point in their life where they defy any type of authority that tries to regulate or direct them. Through governmental programs, family support, and wellness programs, people can ensure a higher graduation rate among these students. Also by becoming more involved in one’s community by trying to get the youth involved, people can effectively help students stay focused on their goals and aspirations. Bullying, an unhealthy environment, and a conflicted family are some of the factors that can affect a child has and adolescent is performance academically, and led them down to a negative path. Based on the information gathered, it is clear that children and adolescents are more vulnerable and can affect them in regards to just about anything. Overall, it is evident that there are many social issues, which can affect a child or adolescent’s education regarding with their stress. It is necessary for people in general to find a way about dealing with problems like race, wealth, relationships, religion, or culture and avoiding it to influence the youth in a negative manner. Psychology is after all the study of how people process things internally and externally and how they go about it. It is important for people to focus that concept on the youth in order to ensure a better future and promote the well-being of them. Reference Seawa Branscombe, N. and Baron, R. (2017).  Social psychology. 14th ed. Boston: Pearson Education. rd, B. L. (2015). Seaward, B. (2012).  Managing stress. Burlington, MA: Jones Bartlett Learning. Rayan, A. H. R. (2017). Mindfulness, quality of life, and severity of depressive symptoms among patients with schizophrenia and patients with major depressive disorder. Journal of Psychosocial Nursing Mental Health Services, 55(5), 40-50. doi:https://dx.doi.org.rdas-proxy.mercy.edu:2048/10.3928/02793695-20170420-05 Cheng, Y. A. (2017). Longer Exposure to Obesity, Slimmer Chance of College? Body Weight Trajectories, Non-Cognitive Skills, and College Completion. Youth Society, 49(2), Retrieved April 18, 2017, from https://journals.sagepub.com/doi/full/10.1177/0044118X14540183 Berger, E., Hasking, P., Martin, G. (2017, February 02). Adolescents’ Perspectives of Youth Non-Suicidal Self-Injury Prevention. Retrieved April 20, 2017, from https://journals.sagepub.com.rdasproxy.mercy.edu:2048/doi/full/10.1177/0044118X13520561 Boylan, R. L., Renzulli, L. (2017, February 02). Routes and Reasons Out, Paths Back: The Influence of Push and Pull Reasons for Leaving School on Students’ School Reengagement. Retrieved April 21, 2017, from https://journals.sagepub.com.rdas-proxy.mercy.edu:2048/doi/full/10.1177/0044118X14522078 Schulze, C., Bryan, V. (2017, February 02). The Gendered Monitoring of Juvenile Delinquents: A Test of Power-Control Theory Using a Retrospective Cohort Study. Retrieved April 23, 2017, from https://journals.sagepub.com.rdas-proxy.mercy.edu:2048/doi/full/10.1177/0044118X14523478

Podcast Episode 67 Ten PANCE and PANRE Board Review Audio Questions

The Audio PANCE and PANRE Episode 67 The Audio PANCE/PANRE - Ten PA Board Review Exam Questions Welcome to episode 67of the Audio PANCE and PANRE PA Board Review Podcast. Join me as Icover ten PANCE and PANRE Board review questions from the SMARTYPANCE course content following the NCCPA content blueprint (download the FREE cheat sheet). This week we willbe coveringten general board review questions based on theNCCPA PANCE and PANRE Content Blueprint. Below you will find an interactive exam to complement the podcast. I hope you enjoy this free audio component to the examination portion of this site. The full boardreview includes over 2,000 interactive board review questions andis available to all members of thePANCE and PANRE AcademyandSMARTYPANCEwhich are now bundled together into one very low price. You can download and listen to pastFREE episodes here,oniTunes, onGoogle Play MusicorStitcherRadio. You can listen to the latest episode, take an interactive quizand download your results below. Listen Carefully Then Take The Practice Exam If you can't see the audio player click here to listen to the full episode. Podcast Episode 67: 10 Question PANCE and PANREPodcast Quiz The following questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE PANRE Board Review Website. If you are a member you will be able to log in and view this interactive video lesson. A 26-year-old female presents with several pruritic lesions on her dorsal forearms. The lesions are erythematous with vesicles, with a few beginning to weep. She works in a photography laboratory but denies any other possible exposures. Which of the following is the most useful diagnostic test? A. VDRL serology B. KOH prep C. Patch testing D. Gram's stain Click here to see the answer C. Patch testing with a suspected agent is usually positive in cases of allergic contact dermatitis A. VDRL serology is useful in the diagnosis of syphilis, not contact dermatitis B. KOH prep is used for diagnosis of fungal infections, not contact dermatitis D. Grams stain is useful in the diagnosis of bacterial infections, not contact dermatitis 2. An elderly female presents for evaluation of exertional syncope, dyspnea, and angina. She admits that previous to these symptoms she had insidious progression of fatigue that caused her to curtail her activities. Which of the following is the most likely diagnosis? A. Aortic stenosis B. Aortic regurgitation C. Mitral stenosis D. Mitral valve prolapse Click here to see the answer A. The major symptoms of aortic stenosis are exertional syncope, dyspnea, and angina. Symptoms do not become apparent for a number of years and usually are not present until the valve is narrowed to less than 0.5 cm to 2 cm of the valve surface area. B. Patients with aortic regurgitation are likely to complain of an uncomfortable awareness of their heart, especially when lying down. These patients develop sinus tachycardia with exertion and complain of palpitations and head pounding with activity. C. The symptoms related to mitral stenosis are related to increased pulmonary pressure after the left atrium can no longer overcome the outflow obstruction. D. Patients with mitral valve prolapse are typically asymptomatic throughout their lives, although a wide range of symptoms is possible. When symptoms do occur, palpitations from arrhythmias are most common along with lightheadedness. Syncope is not part of this disease process. 3. A 40-year-old female G5P5 complains of small quantities of urine leaking when she coughs, sneezes, or laughs. Her genitourinary examination is unremarkable and her urinalysis is normal. At this time, which of the following is the most appropriate management plan? A. Refer for a cystoscopy B. Recommend Kegel exercises C. Refer for surgical correction D. Recommend hormone replacement therapy Click here to see the answer B. Strengthening the pelvic muscles by Kegel exercises and emptying the bladder frequently may resolve the problem. A. Conservative therapy for stress incontinence should be attempted prior to any evaluation, such as cystoscopy, that might indicate the need for surgical correction D. There is no indication in the history for hormone replacement therapy and no vaginal atrophy was noted on pelvic examination 4. A 62-year-old male presents with complaints of vague epigastric abdominal pain associated with jaundice and generalized pruritus. Physical examination reveals jaundice and a palpable non-tender gallbladder but is otherwise unremarkable. Which of the following is the most likely diagnosis? A. Viral hepatitis B. Pancreatic cancer C. Acute cholecystitis D. Gilbert's syndrome Click here to see the answer B. Pancreatic cancer is suggested by the vague epigastric pain with jaundice resulting from biliary obstruction due to cancer involving the pancreatic head. The presence of a palpable non-tender gallbladder (Courvoisiers sign) also indicates obstruction due to the cancer A. While viral hepatitis may cause jaundice, the liver is enlarged and tender C. While acute cholecystitis may present with jaundice and an enlarged gallbladder, the pain is classically colicky and located in the right upper quadrant. On physical examination with deep inspiration and palpation of the right subcostal area increased pain and respiratory arrest (Murphys sign) is usually seen. D. Gilberts syndrome is the most common of the hereditary hyperbilirubinemias. It is most often diagnosed near puberty or adult life based on results of a comprehensive metabolic panel. 5. Which of the following would you expect on physical examination in a patient with mitral valve stenosis? A. Systolic blowing murmur B. Opening snap C. Mid-systolic click D. Paradoxically split S2 Click here to see the answer B. Mitral stenosis is characterized by a mid-diastolic opening snap A. Mitral stenosis is a diastolic, not a systolic murmur C. Mid-systolic clicks are noted in mitral valve prolapse, not mitral stenosis D. Paradoxical splitting of S2 occurs in aortic stenosis, not mitral stenosis Review PANCE and PANRE Valvular disorders pearls 6. A positive Wood's light examination (fluorescence) demonstrates A. viral infection with herpes zoster B. bacterial infection with Treponema pallidum C. parasitic infestation with Pediculus humanus D. mycotic infection with Microsporum canis Click here to see the answer D. Microsporum causes tinea capitis and fluoresces blue-green under Woods light A. Lesions of herpes, Treponema, and Pediculus infections do not fluoresce. Review topic PANCE Dermatologic system dermatophyte infections 7. In which of the following patients would one most likely find acanthosis nigricans? A. A 55-year-old obese female with hyperinsulinemia B. A 55-year-old male with an enlarged spleen and pancytopenia C. A 24-year-old female with increased Lyme titers D. A 60-year-old male with increased triglycerides Click here to see the answer A. Acanthosis nigricans is associated with patients who have hyperinsulinemia B. Hairy cell leukemia is associated with an enlarged spleen and pancytopenia. Acanthosis nigricans is not a cutaneous manifestation C. Erythema chronicum migrans is the characteristic lesion associated with Lyme disease D. Eruptive xanthelasma is associated with increased triglycerides 8. A 65-year-old male presents with back pain two days after he was shoveling snow. The patient complains of pain in his low back that radiates into his buttocks, posterior thigh and calf, and the bottom of his foot. There is associated numbness of the lateral and plantar surface of his foot. Which of the following disc herniations is most likely to be affected? A. L3-L4 B. L4-L5 C. L5-S1 D. S1-S2 Click here to see the answer C. The S1 nerve root impingement is most likely to occur from the herniation of the L5-S1 disc space. The S1 disc affects Achilles reflex, the gastrocnemius and soleus muscles, and the abductor hallucis and gluteus maximus muscles. 9. A 22-year-old female presents to the emergency department with a rapid heart rate. She appears quite thin and dehydrated. She denies that she is thin, stating "I am so fat that I can hardly stand myself! That is why I exercise every day." She runs twelve to fifteen miles a day, and on weekends also bicycles forty to fifty miles. Her LMP was six months ago. On exam, she is 5' 6" tall and weighs 98 pounds. Temp 98 degrees F, pulse 100, respirations 18, BP 98/60. EKG shows sinus tachycardia. Laboratory findings include Na 138 mEq/L, K 2.8 mEq/L, Cl 91 mEq/L, BUN 35 mg/dL, Creatinine 1.1 mg/dL. Which of the following is the next most appropriate treatment? A. Propylthiouracil (PTU) and individual psychotherapy B. Hormone replacement and cognitive therapy C. Weight restoration and family therapy D. IV hydration and antidepressant therapy Click here to see the answer C. Anorexia nervosa requires a comprehensive, multidisciplinary approach to treatment that integrates medical management, individual psychotherapy, and family therapy. Currently, the best results have been shown with weight restoration accompanied by family therapy for patients with adolescent-onset anorexia nervosa and individual therapy for patients with onset after 18 years of age. Inpatient treatment is often required. A. Propylthiouracil is used to treat hyperthyroidism, not anorexia nervosahttps://smartypance.com/lessons/ear-disorders/inner-ear-pearls/acoustic-neuroma/ B. Hormone replacement is not indicated for the amenorrhea of anorexia nervosa, but nutritional support may help. D. Antidepressant therapy may be useful in bulimia nervosa 10. A 52-year-old female presents with complaints of intermittent episodes of dizziness, tinnitus, and hearing loss in the right ear for 6 months. She describes the dizziness as the "room spinning around her," with the episodes typically lasting for 2 to 4 hours. Physical examination reveals horizontal nystagmus and right ear hearing loss, but the remainder of the examination is unremarkable. Which of the following is the most likely diagnosis? A. Acute labyrinthitis B. Positional vertigo C. Acoustic neuroma D. Mnire's syndrome Click here to see the answer D. Mnires syndrome uhttps://smartypance.com/lessons/ear-disorders/inner-ear-pearls/vertigo-reeldx294/sually presents with episodes of vertigo that last from 1 to 8 hours, sensorineural hearing loss and tinnitus. A. Acute labyrinthitis typically presents with an acute onset of continuous vertigo that lasts several days to a week and is associated with nausea and vomiting. It does not have any associated auditory or neurologic symptoms. B. Positional vertigo occurs following changes in head positioning with very brief, less than 1 minute, episodes. Nystagmus occurs following the position change. C. Acoustic neuroma typically presents with hearing loss and tinnitus. The neuroma grows slowly and central compensatory mechanisms can prevent or minimize the vertigo. Vertigo, when present, is continuous and not episodic. Looking for all the podcast episodes? This FREE series is limited to every other episode, you can download and enjoy the complete audio series by joiningThe PANCE and PANRE Exam Academy+ SMARTYPANCE I will bereleasing new episodes every few weeks. The Academy isdiscounted, so sign up now. 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Download .et_bloom .et_bloom_optin_5 .et_bloom_form_content { background-color: #e5e0da !important; } .et_bloom .et_bloom_optin_5 .et_bloom_form_container .et_bloom_form_header { background-color: #b24a49 !important; } .et_bloom .et_bloom_optin_5 .carrot_edge .et_bloom_form_content:before { border-top-color: #b24a49 !important; } .et_bloom .et_bloom_optin_5 .carrot_edge.et_bloom_form_right .et_bloom_form_content:before, .et_bloom .et_bloom_optin_5 .carrot_edge.et_bloom_form_left .et_bloom_form_content:before { border-top-color: transparent !important; border-left-color: #b24a49 !important; } @media only screen and ( max-width: 767px ) {.et_bloom .et_bloom_optin_5 .carrot_edge.et_bloom_form_right .et_bloom_form_content:before, .et_bloom .et_bloom_optin_5 .carrot_edge.et_bloom_form_left .et_bloom_form_content:before { border-top-color: #b24a49 !important; border-left-color: transparent !important; } }.et_bloom .et_bloom_optin_5 .et_bloom_form_content button { background-color: #445a6d !important; } .et_bloom .et_bloom_optin_5 .et_bloom_form_content .et_bloom_fields i { color: #445a6d !important; } .et_bloom .et_bloom_optin_5 .et_bloom_form_content .et_bloom_custom_field_radio i:before { background: #445a6d !important; } .et_bloom .et_bloom_optin_5.et_bloom_optin .et_bloom_border_letter { background: repeating-linear-gradient( 135deg, #445a6d, #445a6d 10px, #fff 10px, #fff 20px, #f84d3b 20px, #f84d3b 30px, #fff 30px, #fff 40px ) !important; } .et_bloom .et_bloom_optin_5 .et_bloom_form_content button { background-color: #445a6d !important; } .et_bloom .et_bloom_optin_5 .et_bloom_form_container h2, .et_bloom .et_bloom_optin_5 .et_bloom_form_container h2 span, .et_bloom .et_bloom_optin_5 .et_bloom_form_container h2 strong { font-family: "Open Sans", Helvetica, Arial, Lucida, sans-serif; }.et_bloom .et_bloom_optin_5 .et_bloom_form_container p, .et_bloom .et_bloom_optin_5 .et_bl oom_form_container p span, .et_bloom .et_bloom_optin_5 .et_bloom_form_container p strong, .et_bloom .et_bloom_optin_5 .et_bloom_form_container form input, .et_bloom .et_bloom_optin_5 .et_bloom_form_container form button span { font-family: "Open Sans", Helvetica, Arial, Lucida, sans-serif; } The Daily PANCE and PANREGet 60 days of PANCE and PANRE Board Certified Review Questions and Answers delivered directly to your inbox. 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Reflecting Body Images from American Culture - 1470 Words

Sara Brown 12-7-05 Eng 101 MW Isbell J Reflecting Body Images from American Culture Currently in America Culture there is a prevailing desire to become thin. Between five per cent and ten per cent of girls and women (i.e. five-ten million people) and one million boys and men suffer from eating disorders, including anorexia, bulimia, binge eating disorder, or other associated dietary conditions. (http://www.annecollins.com/eating-disorders/statistics.htm) So many people are influenced by the media that it transforms their own self image into unrealistic ideas leading many adolescent females and some males to eating disorders. Our society is driven for individual control thus forming the judgment that fatness is a loss of self-control†¦show more content†¦(Stearns Pg. 72) Dieting soon became natural for women and the sexuality was less modest. Obese women were becoming ridiculed for being overweight, literature aimed at the very groups being insulted, women were the clear targets. Are you aware that fatness has destroyed your sex appeal and made you look olde r, somewhat like a buffoon whom people are inclined not to take seriously in any area or on any level.(Stearn Pg. 83, 16) Entries such as this were written in books such as Murray Siegel (1971), Think Thin or Glamour, Glucose and Glands by Frank J. Wilson (1956). This time period was also when women were stepping into the workforce with great strides and if the woman was over weight, she was looked upon as unreliable and lazy. (Stearns) Women became an object of mockery, an example of no self-discipline and social failures if they were not thin. From the mid nineteen hundreds to present times the media has greatly influenced societys acceptance on body image. Even today, women are still mocked for being obese. Heavier women are a continued target in todays society by magazines containing headlines such as How to lose weight. and How to be skinner. 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