By E. Umbrak. Carthage College.

You are not usually expected to give a reference list at the end of your answer sildalis 120mg amex. Write clearly Exams are handwritten and as students are under pressure to complete the answers as quickly as possible order 120mg sildalis amex, legibility often suffers. Although you should not slow yourself down by trying to write as neatly as possible, it is still important that the marker can decipher your scribbles. Someone marking around 200 papers will not want to spend ten minutes trying to work out individ­ ual letters and words. Illegible work is likely to be unmarked, meaning you will lose precious points. Astute editing will also help improve the quality and accuracy of your work. Emergency solutions Sometimes plans go astray and you will need to take emergency action: ° Running out of time – jot down, in note form, the points that would have completed your essay. Indicate you know that the information is from another source by using a general reference like ‘researchers have found’. For example, if you have forgotten the side effects of a drug, describe how you would find them out. Summary Points ° Summative assessments are set at the end of a study unit, term or academic year. It is distinguished from other essays submitted as coursework by its length and detailed treatment of its subject. Each student will make their own choice of topic, unlike set essays where all the students answer the same question. The content of the dissertation will represent the student’s independent study of the subject matter, and will extend beyond the theory and practical applications for­ merly taught on the course.

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He learned that if his calorie consumption chart was even close to accu- rate quality sildalis 120 mg, his diet and eating habits were definitely not the cause of his obesity buy sildalis 120 mg visa. He immediately made an appointment with a well-known internist in town because he felt his fam- ily doctor was not responsive. Making the Diagnosis On the day of his appointment, Pedro took his Eight Step notebook, his blood test results from the family doctor, his calorie journal, and his sense of humor to the internist’s office. He told the doctor he wanted to be so thin he’d have to jump around in the shower to get wet. The internist laughed and after reviewing Pedro’s notebook, he responded that he didn’t know if he could get Pedro that thin, but he was reasonably sure he could make him a lot better. He said he was very impressed with Pedro’s hard work and then gave Pedro a blood and urine test and a computerized tomography (CT) scan. The doctor felt reasonably sure he could give his patient not only a diagnosis but also a cure. When all the test results came back, the doctor told Pedro he had developed Cushing’s syndrome, also known as hypercortisolism. This is a metabolic disorder that occurs when excess cor- tisol circulates in the bloodstream. All the key indicators were found in Pedro’s notebook: the round face and extra fatty tissue in the neck; the thinning skin (which accounted for the bright red stretch marks); the excess beard growth; his obesity, weakness, and fatigability. In fact, Pedro’s metabolic condition causes a certain pecu- liar pattern of obesity that results in a round (moon) face and obesity around the trunk (centripetal obesity). He explained that Pedro’s adrenal glands were producing too much cor- tisol, which in turn caused all his symptoms. The CT scan revealed a small 144 Diagnosing Your Mystery Malady adrenal adenoma, or benign tumor.

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Rosenbaum received the information in Maria’s notebook cheap sildalis 120mg without prescription, it looked very similar to Jennifer’s buy cheap sildalis 120mg line, but Maria was too weak to fill out much of it. General Weakness • Quality and Character: Overall muscle weakness as if I had the flu all the time. Muscle Weakness • Quality and Character: I feel like a straw doll but have no aches or pains that go with it. That’s when I started gaining weight, so I began eating less; exercising more; and taking soy products, eve- ning primrose oil, and other food supplements. Exercise used to give me more energy; now my weakness is persistent and nothing makes 154 Diagnosing Your Mystery Malady it better although exercising now can make it worse. Step Four: Do a Family Medical History and Determine If You Have or Had Any Blood Relatives with a Similar Problem. My father died of colon cancer at the age of seventy-one, but he was heavy and never took care of himself. My mother’s brother also had cancer, and my mother had skin can- cer from which she ultimately died. My sisters are living and generally healthy, although my elder sister is obese like my father and has high blood pressure. Step Five: Search for Other Past or Present Mental or Physical Problems. In the past, I considered myself a healthy person but never felt better than when I started working out. After my last child left for school, I was treated for depression with Prozac. Step Six: Categorize Your Current and Prior Significant Medical Problems by Etiology. I used to think my worth was about being a mom so when my last child left home, I felt lost. Going to the clubs on South Beach and having younger men act interested in me also helped me feel good about myself.

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