Writte By Joe Bollini Brevard, NC I DIDNT DO IT How The Simpsons Affec

Writte by Joe Bollini Brevard, NC I DIDN'T DO IT How The Simpsons Affects Kids The Simpsons is one of Americas most mainstream TV programs. It positions as the main TV program for watchers under eighteen years old. Notwithstanding, the goals that The Simpsons passes on are not generally healthy, here and there not even in great taste. It is inescapable that The Simpsons is influencing youngsters. Matt Groening took up attracting to escape from his difficulties in 1977. At that point, Groening was working for the L.A. Peruser, a free week after week paper. He started dealing with Life in Hell, an entertaining funny cartoon comprising of individuals with bunny ears. The L.A. Peruser got a duplicate of his funny cartoon and preferred what they saw. Life in Hell step by step turned into a typical funny cartoon in many free weeklies and school papers the nation over. It even built up a religion status. (Varhola, 1) Life in Hell drew the consideration of James L. Creeks, maker of works, fo r example, Taxi, The Mary Tyler Moore Show, and Terms of Endearment. Streams initially needed Groening to make an energized pilot of Life in Hell. Groening decided not to do as such in dread of loosing eminences from papers that printed the strip. Groening gave Brooks an overweight, thinning up top dad, a mother with a blue bee sanctuary haircut, and three repulsive spiky haired youngsters. Groening planned for them to speak to the regular American family who love one another and make each other insane. Groening named the characters after his own family. His folks were named Homer and Margaret and he had two more youthful sisters named Lisa and Maggie. Bart was a re-arranged word for imp. Groening picked the last name Simpson to seem like the commonplace American family name. (Varhola, 2) Brooks chose to put the 30 or 60 second livelinesss on between plays on The Tracy Ullman Show on the ineffective Fox arrange. Cast individuals Dan Castellaneta and Julie Kavner did the voices of Ho mer and Marge. Yeardley Smith (later to star in Herman's Head) did the voice of Lisa. Nancy Cartwright did the voice of Bart. Cartwright recently provided the voices for some, kid's shows, including Galaxy High, Fantastic Max, Richie Rich, Snorks, Pound Puppies, My Little Pony, and Glo-Friends. Tracy Ullman later added Cartwright to her cast. (Dale and Trich, 11) Brooks, Groening, and Sam Simon, Tracy Ullman's maker, needed to transform the Simpson family into their own show. The Fox arrange was searching for material to interest more youthful watchers. The main show they had that drew a youthful crowd was Married With Children. To Fox's pleasure, The Simpsons spared the system from close to disappointment. (Varhola, 3) On December 17, 1989, The Simpsons got their break. The Christmas extraordinary, Simpsons Roasting on an Open Fire broadcast. (Dale and Trich, 19) In the scene, Bart got a tattoo, causing Marge a deep sense of abhorrence. She immediately went through the entirety of the family's Christmas cash to expel Bart's tattoo with a laser. Simultaneously, Homer, still on his morning short breather at 4:00 toward the evening, discovers that he won't get a Christmas reward. At the point when he discovers that Marge is depending on target for Christmas, he concludes that he will do the Christmas looking for the year. He rapidly purchases Marge undies hose, Bart paper, Lisa pastels, and Maggie a pooch toy. At the point when he understands that he isn't doing quite well, he finds a second line of work as a shopping center Santa for the additional cash. In transit home from work, he takes a Christmas tree. The following day at the shopping center, Bart sits on his Dad's lap and pulls down his facial hair. Homer reacts by stifling Bart and making him help improve Christmas. On Christmas Eve, Homer gets his check, $13.70 for more than 40 hours work. Homer takes Bart to the pooch track as a last possibility for Christmas cash. They found a jewel in the third race , Santa's Little Helper. How could this pooch free on Christmas Eve? The chances were 99 to 1, they would have been rich. Homer put the entirety of his cash on Santa's Little Helper, and regrettably, he never at any point wrapped up. As Homer and Bart were

Cyberspace and Human Relationships Essay

Sometime in the past individuals were separated into 2 gatherings: those with social aptitudes that help them in associating with others, and those without the required social abilities to connect along these lines making them retreat into a shell or their own little vacuum of a world. These gatherings no longer exist in today’s world on account of that mechanical wonder that has been connecting social holes in the 21st century, the Internet. The Internet has presented both the socially adroit and clumsy individuals to new types of correspondence that don't make them get tongue tied nor have tangled musings when attempting to identify with others. Utilizing talk room, email, gatherings, blogging, and different types of electronic correspondence has permitted individuals, as an aggregate society to reclassify human connections according to the presence of the internet. The internet, all the more famously known as the Internet has permitted individuals to find the full degree of their social aptitudes inside the protected bounds of their obscure areas and nom de plumes. As per Norman N. Holland in his paper entitled The Internet Regression: Current appraisals state 23 million individuals convey on the Internet from the greater part of the countries on the globe, and that number is expanding at 12% every month. One would ordinarily say that these insights are a decent sign. Individuals are at last speaking with one another paying little heed to nationality, ethnicity, and race. Nothing could be further from reality. Mr. Holland’s explore has demonstrated that: Talking on the Internet, individuals relapse. It’s that straightforward. It very well may be balanced chat on email or many-to-many chat on one of the LISTs or newsgroups. Individuals relapse, communicating sex and animosity as they never would up close and personal. He continues to clarify that these relapses can be found in 3 angles that he terms as Internet primitivism. These demonstrations of primitivism are flaring, sexual animosity, for some odd reason, phenomenal liberality over the Internet. He characterizes flaring as Flying into a typewritten rage at some apparent slight or bungle and is the most widely recognized type of Internet primitivism generally found in discussions, online journals, newsgroups, and messages. Inappropriate behavior is a: Crude solicitations to individuals about whom one knows close to their online marks (which likely could be â€Å"gender-benders† that conceal the sex of the speaker). Much the same as in the physical world, this sort of assault is pointed towards ladies and can happen even in the most expert and scholarly of discussions. Albeit, because of the secrecy that the internet offers, guys additionally get a lot or profane recommendations. At long last, you are presumably pondering with regards to how unprecedented liberality can be viewed as a kind of relapse affected by the utilization of the Internet. Mr. Holland clarifies that The one remark you hear again and again about online correspondence is the transparency, the feeling of sharing and, generally, resistance. Absolute outsiders will surrender hours of their opportunity to send each other research information. Indeed, even merchandise. This is a direct result of the atmosphere of wellbeing and solace that Internet connections give. Mr. Holland tells his perusers that Kristina Ross instituted the term â€Å"Identity play† to characterize this kind of receptiveness. The thought being that People evaluate better approaches for being, frequently in fun loving ways: various callings, the contrary sexual orientation, modified self-depictions. There is a feeling that ‘it doesn’t matter,’ a sentiment of insusceptibility. Summarizing his conviction about Internet connections, he demonstrates that Correspondence on the Internet has its plusses and minuses. The plusses are the liberality and receptiveness. The minuses are forceful flaring, sexual assault, and expanded defenselessness. I think they are cut out of the same cloth: sex and animosity in positive and negative, dynamic and inactive, structures. Both start on account of an absence of inhibitionâ€a relapse. Consequently, he accepts that the connections worked over the Internet permit man to surrender to his most essential creature wants without anybody to reply to straightforward in light of the fact that the Internet can't be controlled nor blue-penciled. The primary issue I see with Internet based association is that the human part of socialization has vanished. The internet gives us a misguided sensation that all is well and good and doesn't give any limits that show the clients how to treat our digital neighbor. Restraint doesn't exist when one doesn't genuinely communicate with others and this offers an alternate sort of opportunity that permits one to communicate too uninhibitedly on occasion in available resources that one would not set out to attempt when up close and personal with someone else. MIT teacher Sherry Turk whose article â€Å"Who Am We? † was distributed by Wire Magazine has discovered that: Computer screens are the new area for our dreams, both suggestive and scholarly. We are utilizing life on PC screens to get settled with better approaches for considering development, connections, sexuality, governmental issues, and personality. Because of the simplicity of making an Internet personality, man has built up the capacity to turn into the Internet character form of a chameleon. It isn't extraordinary for an individual to have more than one online character contingent on the sort of webpage being frequented. Every personality likewise has a going with character and foundation that could either be founded on the genuine character of the individual or completely made up so as to fill a specific need for the person. Presently, as per a 2004 review done by the Elan University/Pew Internet Project: By 2014, utilization of the Internet will build the size of peoples’ informal organizations a long ways past what has customarily been the situation. This will improve trust in the public eye, as individuals have a more extensive scope of sources from which to find and check data about openings for work, individual administrations, regular interests and items. The internet has connected a correspondence hole around the world. It permits us to have an immensely broad interpersonal organization utilizing network sites like Friendster, My Space, and other comparable sites. Utilizing these roads, we have created virtual universes where we can get settled with others and choose if it would be justified, despite all the trouble for us to meet them up close and personal, or in the event that it will be justified, despite all the trouble to address them via telephone. Because of the simplicity of making an Internet personality, man has built up the capacity to turn into the Internet character form of a chameleon. It isn't exceptional for an individual to have more than one online character contingent on the kind of webpage being frequented. Every personality additionally has a going with character and foundation that could either be founded on the genuine character of the individual or completely made up so as to fill a specific need for the person. The presence of the internet has re-imagined one of the most fundamental social and human connections. I am discussing the Dating relationship. Gone are the times of stressing and humiliation over needing to converse with an individual you really like or conversing with an individual you truly need to ask out and dreading being rebuked. Dating administrations, for example, coordinate. com multiply the Internet and, for low month to month charges, the organization needs you to accept that they can discover you that ideal accomplice all using innovation bolstered coordinate creation. A great many individuals overall are pursued comparative administrations in their nations of origin. The inquiries are (1. ) Does it truly work? (2. ) Is there an increasingly prevailing sex in this sort of dating set-up? (3) Have the sex jobs been turned around in view of this new type of finding and going out on the town? (4. ) Dating a matter of trust. Would you be able to confide in somebody you just met on the web? Since the internet permits us to convey from significant stretches, individual and sentimental connections that depend on this field revolves generally around confiding in the other individual. By one way or another, individuals who connect online appear to be progressively happy with discussing them and utilize the secrecy of the Internet as certainty help towards getting increasingly private. Web based dating permits the two members to discover somebody they share a great deal for all intents and purpose with before really going on a physical date. This reduces or dispense with the vulnerability of the physical date since they expect that they definitely know one another and right now realize they are intellectually perfect. Henceforth, an alternate degree of solace and trust. As per Tiberius Brastaviceanu, creator of The Future of Online Dating: Technology-intervened correspondence gives a less upsetting condition where dating individuals can all the more likely control their self-introduction, and better plan. A few signs of this distinction are: Misrepresentation: for different reasons individuals will in general depict a persona that is unreasonable to a more noteworthy degree. End of discussion: trades can be finished suddenly, as this activity bears immaterial results. Closeness: individuals will in general reveal progressively cozy data, as this activity bears less-noteworthy results. Discourteousness: extraordinary practices, regularly repressed in a genuine social condition, are normal in PC interceded correspondence. To be sure, dating nowadays is currently a long ways from when our folks were dating. Possibly on the grounds that dating individuals met online is all the more energizing. It gives and component of shock and as per Brastaviceanu: A definitive reason is that it makes the dating game all the more intriguing, by giving colossal adjustments: closeness, every free dismissal is less hurtful (go here for additional top to bottom), stopping a stillborn connection is less convoluted, access to a bigger pool of potential matches, and so on. Web based dating is a kind of dating administration that depends generally on innovation, and offers daters the likelihood to meet and to impart on the web. Albeit, much the same as anything unrealistic, it has some grave drawbacks that are viewed as similarly as hazardous as speed dating and visually impaired dating. As per Brastaviceanu, these confusions are very like genuine dating burdens

Essay Tips for Effective College Writing

<h1>Essay Tips for Effective College Writing</h1><p>Having an exposition or a proposition submitted to a school or college requires something other than substance and knowledge. Understudies who need to get as well as can be expected do as such by following the correct exposition tips and tricks.</p><p></p><p>The initial step is to set up the paper as indicated by your own style. An article is a living thing that mirrors your insight as an author. As you build up your own style and the manner in which you compose, it assists with realizing that this paper will be perused and assessed by the workforce. Hence, all the additional exertion that you put in before composing won't just assistance your article to get acknowledged, yet additionally improve your composing skills.</p><p></p><p>Always prepare to set up your exposition. Along these lines, you recognize what is to be incorporated and in what group, which empowers yo u to make a succinct yet clear exposition that is linguistically right and is sure about both rationale and style.</p><p></p><p>Writing a school article expects one to compose the significant focuses and thoughts in an organized way. There are four primary regions where you can sort out the data or realities about your theme. These are the creators' rundown, body, supporting proof and end. Along these lines, to compose an exposition effectively, you have to ensure that you put the relevant data in the best possible put in and the suitable request in the text.</p><p></p><p>The following stage in articulating your principle thought is to build up the structure of the paper. In a proper arrangement, the initial segment of the paper begins with a presentation, trailed by the body, at that point decision and an end paragraph.</p><p></p><p>You need to concoct sentence structure that is clear and is linguistically righ t. Utilizing appropriate word and sentence structure help to make the subject of the paper all the more intriguing and inventive. Exceedingly significant data ought to be composed, and so that makes thereader take intrigue. These means will assist with improving your article, in this way expanding the odds of your paper being accepted.</p><p></p><p>There are various exposition composing tips that can assist you with improving your composing aptitudes. Be that as it may, you have to assemble every one of these thoughts before presenting your paper. A smart thought can be destroyed on the off chance that you don't gain proficiency with the specialty of viable and productive writing.</p>

How To Write An Academic Essay - Academic Paper Examples

<h1>How To Write An Academic Essay - Academic Paper Examples</h1><p>Academic exposition tests are significant for the understudies as they may utilize them to have a thought regarding how to plan and present their work. Furthermore, it is likewise significant for the educators and the instructor to have the option to have tests of papers composed by students.</p><p></p><p>For an understudy who needs to realize how to compose a scholastic article, there are numerous assets that might be valuable. A portion of these assets incorporate books or magazines. These assets can give the thoughts and rules all together for the understudies to deliver quality scholastic papers.</p><p></p><p>A understudy should realize that not all understudies need to take propelled classes so as to apply a similar methodology when composing a scholarly article. It is additionally significant for the understudies to realize that there are a few s orts of instructive courses that require various methodologies. The scholarly exposition tests that an understudy has ought to have the option to enable them to comprehend what type obviously they are taking so they won't be mistaken for the subject matter.</p><p></p><p>It is likewise significant for the understudies to comprehend that they ought not present a paper that they don't believe is awesome or a paper that they feel isn't right. An understudy who is in an inappropriate can wind up abandoning paper before it has been finished. This can be baffling for the understudy who is as of now under a great deal of pressure.</p><p></p><p>There are various methodologies that an understudy can utilize when composing a scholarly paper. One methodology that they can take is to have the point that they are dealing with as their topic for the scholarly paper. This can be a theme that they have encountered and they might want to share this invo lvement with the paper.</p><p></p><p>Another approach that an understudy can take is to use the encounters that they have had for an amazing duration so as to make the different article points. It is significant for the understudies to recollect that the tales that they have must be valid about their life can likewise be utilized in the paper that they are composing. The understudy ought to likewise recall that they can even utilize their own encounters just as their background so as to make the data that they present in the essay.</p><p></p><p>Using distinctive exposition tests can enable the understudies to get a thought regarding how to compose a paper and what sort of approach that they should take. There are likewise models that are set up by specialists in the field of training. This is useful in light of the fact that the understudy might have the option to study the various methodologies that they can utilize and which strategi es are not worth utilizing in the scholarly paper.</p><p></p><p>All taking all things together, having the correct data that can assist them with composing a scholastic paper is significant. The understudies can likewise get a ton of help from the numerous assets that are accessible to them when they are getting ready for their scholastic papers.</p>

What Will Californias Bar Exam Entail?

<h1>What Will California's Bar Exam Entail?</h1><p>The first CaliBarre article subjects for July 2020 are here! For those of you that need to see a few words come out of your PC screen, at that point kick back and let them stream from your console. As the spring semester is getting to its end, this is the point at which you can hope to see a few CaliBarre educators accumulate a rundown of their top expectations for California Bar article subjects for July. We'll uncover the expectations when we have them and will refresh you with more data about the point each week.</p><p></p><p>In January, we referenced that word got out that the establishment of Law in California would have been offering courses identified with open intrigue law. The 'Berkeley Law School' has reported this mid year that they will offer a MA program in law which incorporates courses managing social liberties and remote law. Be that as it may, the open door was open just to c ertify law understudies, so it was increasingly similar to a temporary job, and the classes were free. Presently they have been conceding the general public.</p><p></p><p>It will be fascinating to check whether California has better legal opportunity or more terrible legal restriction. Would it be smarter to get more appointed authorities from outside California to guarantee legal assorted variety? Or on the other hand would it be smarter to get more appointed authorities who originate from inside California?</p><p></p><p>It is likely that decided in California will have significantly more scope with their decisions. Because they're from San Francisco, Los Angeles, or Orange County doesn't mean they need to follow indistinguishable decisions from different appointed authorities. Judges can select lawyers who will speak to them under the watchful eye of the California Supreme Court.</p><p></p><p>If California wil l make a third part of government, it is a decent wagered that it won't permit legal interests from bureaucratic courts. It may permit the President to choose decided from outside California, yet that presumably won't occur. This is on the grounds that the individuals in California love federalism, yet they detest the possibility of a three-branch government judiciary.</p><p></p><p>Whether or not one concurs with the international strategy choices made by the California Supreme Court, the reality remains that it is a point of reference that goes far toward establishing California as the most liberal state in the country. Thus, the California Bar Exam will be everywhere as far as sexual orientation, race, and nationality. For those that desire to follow the patterns in more than one classification, it is conceivable to look into the manners in which these progressions sway American society.</p><p></p><p>So don't let California's future vanish in June as I did when I had it. Compose your Bar Essay points for July right now.</p>

The Easiest Companies to Research For Essay Topics

<h1>The Easiest Companies to Research For Essay Topics</h1><p>Writing a paper doesn't need to be troublesome, you simply need to locate the least demanding organizations to explore for article subjects. In the event that you have a decent author, this is typically the snappiest method to get a tolerable outcome. Most scholars realize that a few people need to maintain a strategic distance from this sort of task, yet in case you're great at composing, it tends to be an extremely fun and remunerating experience.</p><p></p><p>This is a paper subject that is so natural to investigate, it will take the vast majority not exactly 60 minutes. You'll see that most organizations that sell understudy items are anything but difficult to investigate for exposition themes, regardless of whether they don't offer a resume composing service.</p><p></p><p>Of course, there's nothing amiss with doing your examination before you begin comp osing your article subjects. Be that as it may, since it's anything but difficult to explore, this is frequently not the best methodology. It's likewise simpler to compose an article online than in a homeroom environment.</p><p></p><p>So, rather than investigating for exposition subjects, you should begin by exploring for a point. Try not to stress over finding the least demanding organizations to investigate for article subjects; rather, center around finding the simplest company.</p><p></p><p>The reason that a great many people come up short at their first prospective employee meeting is on the grounds that they're so anxious. Sadly, prospective employee meet-ups are a troublesome thing to plan for, and except if you have in any event a passing evaluation in a school composing class, you'll need some additional assistance to get readied. Fortunately, this is anything but difficult to do, since you'll have the option to explore for ar ticle points after you've finished your essay.</p><p></p><p>Remember that you have to have a decent report plan so as to be set up for your prospective employee meet-up. Exploration for article points will assist you with guaranteeing that you're set up to confront a flood of inquiries regarding your composing abilities. It might appear to be a pointless cost, yet when you've completed your article, you'll realize that it was worth it.</p><p></p><p>Of course, the least demanding organizations to explore for paper themes aren't generally the most respectable. Ensure that you research altogether before presenting your paper. Simply make sure to begin by investigating for the least demanding organizations to explore for exposition topics.</p>

Pulmonology 1 The Audio PANCE and PANRE Podcast Topic Specific Review Episode 29

Welcome to episode 29of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Over the next few episodes, I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA content blueprint. This week we will be covering 10 topic specific Pulmonology board review questions. 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 pulmonology review includes over 142 pulmonology specific questions andis available to all members of the PANCE and PANRE Academy. You can download and listen to past FREE episodes here,oniTunesor StitcherRadio. You can listen to the latest episode, take an interactive quizand download your results below. Listen Carefully Then Take The Quiz If you can't see the audio player click here to listen to the full episode. Pulmonology PANCE and PANREPodcast Quiz The Audio PANCE and PANRE Pulmonology Quiz 1 Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Start Congratulations - you have completed The Audio PANCE and PANRE Pulmonology Quiz 1. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%% Your answers are highlighted below. Question 1A 45 year-old male presents with sudden onset of pleuritic chest pain, productive cough and fever for 1 day. He relates having symptoms of a "cold" for the past week that suddenly became worse yesterday. Which of the following findings will most likely be seen on physical examination of this patient?Aspoken "ee" heard as "ay"Bhyperresonant percussion noteHint: Consolidation from bacterial pneumonia causes findings of dullness to percussion, late inspiratory crackles and bronchial breath sounds over the involved area.Cwheezes over the involved areaHint: See answer for explanation.Dvesicular breath sounds over involved areaHint: Consolidation from bacterial pneumonia causes bronchial breath sounds over the involved area.Question 1 Explanation: This patient most likely has a bacterial pneumonia with consolidation, which would produce egophony, where a spoken "ee" is heard as "ay."Question 2A foreign body lodged in the trachea that is causing partial obstruction will most likel y produce what physical examination finding?A stridorBaphoniaHint: Aphonia, inability to cough and progressive cyanosis are seen with complete obstruction of the trachea, not partial obstruction.Cinability to coughHint: Aphonia, inability to cough and progressive cyanosis are seen with complete obstruction of the trachea, not partial obstruction.Dprogressive cyanosis Hint: Aphonia, inability to cough and progressive cyanosis are seen with complete obstruction of the trachea, not partial obstruction.Question 2 Explanation: An inspiratory wheeze is called stridor, which indicates a partial obstruction of the trachea or larynx.Question 3On physical examination you note diminished breath sounds over the right lower lobe with decreased tactile fremitus and dullness to percussion. Which of the following is the most likely cause?AasthmaHint: Asthma is characterized by decreased tactile fremitus, but would have resonant to hyperresonant percussion, not dullness.BconsolidationHint: Consolida tion from pneumonia is characterized by dullness to percussion, but would have an increased, not decreased, tactile fremitus.CpneumothoraxHint: pneumothorax is characterized by decreased to absent tactile fremitus, but would have a hyperresonant percussion note, not dullness.Dpleural effusionQuestion 3 Explanation: A decreased tactile fremitus and dullness to percussion would be found in a pleural effusion. No answers yet Question 4Which of the following is essential to make a diagnosis of cystic fibrosis?APositive family historyHint: Cystic fibrosis is a genetic disease, but a positive family history in and of itself is not enough to diagnose the condition.BElevated sweat chlorideCRecurrent respiratory infectionsHint: While recurrent respiratory infections are a classic presentation of cystic fibrosis, the diagnosis relies on confirmation.DElevated trypsinogen levels Hint: Trypsinogen levels are used as a neonatal screening test and if elevated should be followed by more definitive testing to confirm the diagnosis.Question 4 Explanation: The diagnosis of cystic fibrosis is made only after an elevated sweat chloride test or demonstration of a genotype consistent with cystic fibrosis.Question 5An adult patient who is HIV positive receives a PPD. He develops an area of induration that measures 8 mm after 48 hours. Which of the following is the most appropriate interpretation of this test result?Apositiv eBnegativeHint: See answer for explanationCactive infectionHint: A positive PPD identifies patients that have been infected with Mycobacterium tuberculosis, but does not indicate whether the disease is currently active or inactive.Dfalsely negative Hint: See answer for explanationQuestion 5 Explanation: A reaction size of greater than or equal to 5 mm in a HIV positive patient is considered a positive tuberculin skin test reaction. CDC PPD Interpretation GuidelinesQuestion 6A 23 year-old female with history of asthma for the past 5 years presents with complaints of increasing shortness of breath for 2 days. Her asthma has been well controlled until 2 days ago and since yesterday she has been using her albuterol inhaler every 4-6 hours. She is normally very active, however yesterday she did not complete her 30 minutes exercise routine due to increasing dyspnea. She denies any cough, fever, recent surgeries or use of oral contraceptives. On examination, you note the presence of prolonged expiration and diffuse wheezing. The remainder of the exam is unremarkable. Which of the following is the most appropriate initial diagnostic evaluation prior to initiation of treatment?Achest x-rayHint: A chest x-ray should be ordered in an asthmatic patient only if you are concerned about the presence of pneumonia or pneumothorax, neither of which is supported by the H A peak flow reading will help you to gauge her current exte nt of airflow obstruction and is helpful in monitoring the effectiveness of any treatment interventions. Question 7A patient presents with a history of progressive worsening of dyspnea over the past several years. He gives a history of having worked as a ship builder for over 50 years. He denies any alcohol or tobacco use. On examination you note clubbing and inspiratory crackles. Which of the following chest x-ray findings support your suspected diagnosis?Ahyperinflation and flat diaphragmsHint: Chest x-ray findings of hyperinflation and flat diaphragms suggest long-standing chronic obstructive lung disease.Binterstitial fibrosis and pleural thickeningCcavitary lesions involving the upper lobesHint: Chest x-ray findings of cavitary lesions involving the upper lobes suggest pulmonary tuberculosis.D"eggshell" calcification of hilar lymph nodes Hint: Chest x-ray findings of "eggshell" calcification of hilar lymph nodes strongly supports the diagnosis of silicosis. It occurs in workers from mines, foundries, sandblasting, and glass manufacturing.Question 7 Explanation: This patient most li kely has asbestosis, which is supported by his occupation as a ship builder and clinical presentation as noted above. Some occupations are associated with an elevated risk of asbestos exposure. Historically, naval shipyard workers are among the most frequently exposed. It is likely that workers who served between World War II and the Korean War came in contact with dangerous levels of asbestos, increasing their chances of developing diseases like asbestos-related lung cancer and mesothelioma. Chest x-ray findings include interstitial fibrosis, pleural thickening and calcified pleural plaques on the diaphragm or lateral chest wall. Question 8You are called to the nursery to see a male infant, born by uncomplicated vaginal delivery. He weighs 2,600 grams and has one deep crease on the anterior third of each foot. Respirations are 88 breaths/minute with expiratory grunting and intercostals retractions. He is cyanotic on room air and becomes pink when placed in 60% oxygen. Chest x-ray shows atelectasis with air bronchograms. Which of the following is the most likely diagnosis?Aneonatal pneumoniaHint: While tachypnea, grunting, retractions and cyanosis may be signs of neonatal pneumonia, they are primarily late findings of progressive respiratory distress and would not be seen immediately at the time of delivery. A chest x-ray in pneumonia would also most commonly reveal an infiltrate or effusion.Bcongenital heart diseaseHint: While congenital heart disease may present with cyanosis, the chest x-ray will reveal a cardiac abnormality, such as cardiomegaly.Chyaline membrane diseaseDchronic lung disease of prematurity Hint: Chronic lung disease of prematurity is a complication in about 20% of infants with hyaline membrane disease. It is defined as respiratory symptoms, oxygen requirement and chest x-ray abnormalities at 1 month of age so it cannot be diagnosed at this time in this newborn.Question 8 Explanation: Hyaline membrane disease is the most common cause of respiratory distress in the premature infant. The infant typically presents with tachypnea, cyanosis and expiratory grunting. A chest x-ray reveals hypoexpansion and air bronchograms.Question 9A 15 year-old male presents with a 1 week history of hacking non-productive cough, low grade fever, malaise and myalgias. Examination is unremarkable except for a few scattered rhonchi and rales upon auscultation of the chest. The chest x-ray reveals interstitial infiltrates and a cold agglutinin titer was negative. Which of the following is the most likely diagnosis?Aacute bronchitisHint: While the patient's clinical symptoms of dry cough and rh onchi support this diagnosis, the chest x-ray would be normal or only show a mild increase in bronchovascular markings, not infiltrates.Bviral pneumoniaCmycoplasma pneumoniaHint: While the gradual onset of symptoms suggest mycoplasma, the negative cold agglutinin titer makes this less likely.Dpneumococcal pneumonia Hint: In older children the signs and symptoms of pneumococcal pneumonia are similar to an adult and consist of an abrupt onset of cough, fever and chills. The chest x-ray would reveal a lobar consolidation, not interstitial, picture.Question 9 Explanation: The patient's clinical symptoms as well as chest x-ray findings and negative cold agglutinin titer are most consistent with viral pneumonia. Cold agglutinin would likely be positive in a patient with mycoplasma pneumonia. Question 10A 53 year-old female status post abdominal hysterectomy 3 days ago suddenly develops pleuritic chest pain and dyspnea. On exam she is tachycardic and tachypneic with rales in the left lower lobe. A chest x-ray is unremarkable and an EKG reveals tachycardia. Which of the following is the most likely diagnosis?AatelectasisHint: Small atelectasis is commonly asymptomatic, while large atelectasis may produce signs of dyspnea and cough. Exam reveals absence of breath sounds in the area involved and dullness to percussion. A chest x-ray would reveal various findings dependent on the location of the atelectasis, but would not be normal.BpneumothoraxHint: While a pneumothorax commonly presents with pleuritic chest pain and dyspnea, exam would reveal the presence of diminished breath sounds and hyperresonance on the involved side. A chest x-ray would reveal presence of a pleural line on the expiratory chest x-ray.Cpulmonary embolismDmyocardial infarctionHint: While a myocardial infarction usually presents with dyspnea, the chest pain is not usually pleuritic in nature. An EKG would commonly reveal ST segment changes, which would be consistent with ischemia or infarct.Question 10 Explanation: Risk factors for pulmonary embolism include advanced age, surgery and prolonged bedrest. While the diagnosis of pulmonary embolism is difficult due to nonspecific clinical findings, the most common symptoms include pleuritic chest pain and dyspnea associated with tachypnea. Chest x-ray and EKG are usually normal. Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results There are 10 questions to complete. List Return Shaded items are complete. 12345678910End Return You have completed questions question Your score is Correct Wrong Partial-Credit You have not finished your quiz. If you leave this page, your progress will be lost. Correct Answer You Selected Not Attempted Final Score on Quiz Attempted Questions Correct Attempted Questions Wrong Questions Not Attempted Total Questions on Quiz Question Details Results Date Score Hint Time allowed minutes seconds Time used Answer Choice(s) Selected Question Text All doneNeed more practice!Keep trying!Not bad!Good work!Perfect! 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. I will bereleasing new episodes every few weeks. The Academy is currently discounted, so sign up now. Resources and Show Notes: My list of recommended PANCE and PANRE review books This Podcast is also available on iTunes and Stitcher Radio for Android iTunes:The Audio PANCE AND PANRE Podcast iTunes Stitcher Radio:The Audio PANCE and PANRE Podcast Stitcher document.createElement('audio'); http://traffic.libsyn.com/pasquini/Pulmonology_1_The_Audio_PANCE_and_PANRE_Podcast_Topic_Specific_Review_Episode_29.mp3Podcast: Download () | EmbedSubscribe: Apple Podcasts | Android | Email | Google Podcasts | Stitcher | RSS | PANCE and PANRE Podcast PlayerView all posts in this seriesThe Audio PANCE and PANRE Board Review Podcast Episode 1The Audio PANCE and PANRE Board Review Podcast Episode 3The Audio PANCE and PANRE Board Review Podcast Episode 5The Audio PANCE and PANRE Board Review Podcast Episode 7The Audio PANCE and PANRE Board Review Podcast Episode 9The Audio PANCE and PANRE Board Review Podcast Episode 11The Audio PANCE and PANRE Board Review Podcast Episode 13The Audio PANCE and PANRE Board Review Podcast Episode 15The Audio PANCE and PANRE Board Review Podcast Episode 17The Audio PANCE and PANRE Board Review Podcast Episode 19The Audio PANCE and PANRE Board Review Podcast Episode 21The Audio PANCE and PANRE Board Review Podcast Episode 23The Audio PANCE and PANRE Board Review Podcast Episode 25Cardiology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 27Pulmonology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 29Gastroenterology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 31EENT 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 33Genitourinary 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 35Musculoskeletal 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 37Reproductive System 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 39Episode 41: The Audio PANCE and PANRE Board Review PodcastEpisode 43: The Audio PANCE and PANRE Board Review PodcastMurmur Madness: The Audio PANCE and PANRE Episode 45Episode 47: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 49: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisod e 51: The Audio PANCE and PANRE Board Review Podcast Comprehensive Audio QuizEpisode 53: General Surgery End of Rotation Exam The Audio PANCE and PANRE PodcastEpisode 55: The Audio PANCE and PANRE Board Review PodcastEpisode 57: The Audio PANCE and PANRE Board Review PodcastEpisode 59: Emergency Medicine EOR The Audio PANCE and PANRE Board Review PodcastEpisode 61: The Audio PANCE and PANRE Board Review PodcastEpisode 63: The Audio PANCE and PANRE PA Board Review PodcastPodcast Episode 65: Hepatitis B Breakdown With Joe Gilboy PA-CPodcast Episode 67: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 69: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 71: Ten PANCE and PANRE Board Review Audio QuestionsPodcast Episode 73: Ten FREE PANCE and PANRE Audio Board Review QuestionsPodcast Episode 75: Ten FREE PANCE and PANRE Audio Board Review QuestionsPodcast Episode 77: The Audio PANCE and PANRE Board Review Podcast You may also like -Genitourinary 1: The Audio PANCE and PANRE Board Review Podcast Topic Specific Review Episode 35Welcome to episode 35of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as I continue tocover topic specific PANCE and PANRE review from the Academy course content following the NCCPA content []Cardiology 1: The Audio PANCE and PANRE Podcast Topic Specific Review Episode 27Welcome to episode 27of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Over the next few episodes I will be covering topic specific PANCE and PANRE review from the Academy course content following the NCCPA []Episode 41: The Audio PANCE and PANRE Board Review PodcastWelcome to episode 41of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as Icover 10 PANCE and PANRE board review questions from the Academy course content following the NCCPA content []