European History Essay Example | Topics and Well Written Essays - 2000 words

European History - Essay Example Really taking shape of the Treaty of Versailles that adequately finished World War I, France led the harmony meeting and decided to have Germany, the person who began the war be appropriately rebuffed and the terrains it seized returned. Germany marked the arrangement yet proposed a few corrections. All things considered, the arrangement was to the awareness of Germans motivation to have a score settled and that came in World War II. In the assessments of many, the bargain was excessively brutal on Germany and France is presently being found in awful light World War II. In 1939, World War II came, and this went on until 1945.1 The war spread out to Europe, Asia, Mediterranean and Middle East, Africa bringing about Allied triumph where losses were 62 million, and 37 million of these were regular citizens and 25 million were military. The two gatherings that were battling were the Allies made out of Soviet Union, UK and Commonwealth, USA, France/Free France, China, Poland, and Australia; and the Axis made out of Germany, Japan, Italy, Romania, Hungary, Bulgaria, and Vichy France. 2 World War II was a genuinely worldwide clash with untold human wretchedness that started on September 1, 1939 when German attacked Poland. Nations that took an interest in World War I were similar nations engaged with World War II. On September 3, 1939 Britain, France, Australia and New Zealand pronounced war on Germany and Canada followed seven days after the fact. In the mean time, the United States joined the contention in December 1941 after Japan assaulted Pearl Harbour.3 Bargains. After World War II, delegates from 21 part nations of the United Nations met in Paris on July 29, 1946, to draft arrangements with Italy, Hungary, Bulgaria, Romania, and Finland.4 Representatives of the United States, Britain, the Soviet Union, and France marked the bargains in Paris on Feb. 10, 1947. Outskirt strongholds as gave in the bargains were to be restricted uniquely to keeping inward security. Additionally, ensures against racial segregation and the resurrection of extremist governments were given for.5 Because of the overwhelming encounters of war that the countries experienced particularly in World War II, these two assurances are justifiable. Additionally, the Balkan arrangements accommodated free route of the Danube. Requests. Toward the finish of the war, millions were rendered destitute, the European economy had crumpled, and 70% of the European mechanical foundation was destroyed.6 The Eastern victors claimed installment of war reparations from the crushed countries, and in the Paris Peace Treaty, the adversaries of Soviet Union which were Hungary, Finland and Romania, were required to pay $300,000,000 each to the Soviet Union. Italy was required to pay $360,000,000, shared mostly between Greece, Yugoslavia and the Soviet Union.7 Meanwhile, the Western victors in World War II didn't request pay from the vanquished countries. Rather, an arrangement set up by U.S. Secretary of State George Marshall, the European Recovery Program, otherwise called the Marshall Plan, required the U.S. Congress to dispense billions of dollars for the recreation of Europe.8 As reflected in Table 1, the breakdown was as per the following - pay to the wWII victors at 1938 costs (Postponed by essayist

Why its Important to Write Right in the Legal Profession †And 5 Common Writing Pitfalls to Avoid

Aristotle And Politics

Aristotle And Politics Essay annonAristotle (b. 384 d. 322 BC), was a Greek scholar, logician,and researcher. Alongside his instructor Plato, Aristotle is generallyregarded as one of the most compelling antiquated masterminds in a numberof philosophical fields, including political hypothesis. Aristotle wasborn in Stagira in northern Greece, and his dad was a courtphysician to the ruler of Macedon. As a youngster he contemplated inPlatos Academy in Athens. After Platos passing he left Athens toconduct philosophical and organic research in Asia Minor andLesbos, and he was then welcomed by King Philip II of Macedon to tutorhis youthful child, Alexander the Great. Not long after Alexander succeededhis father, united the triumph of the Greek city-states, andlaunched the intrusion of the Persian Empire. It was in thisenvironment that Aristotles perspectives and thoughts of legislative issues created. As Alexanders instructor, Aristotle had a nearby bind to the politicalpowers of Athens. As a result of this tie Aristotle composed Politics as aguide to rulers regarding how to oversee a nation. In Politics Aristotlelays out his optimal type of Government. It contains thought provokingdiscussions on the job of human instinct in legislative issues, the connection ofthe individual to the express, the spot of ethical quality in governmental issues, thetheory of political equity, the standard of law, the examination andevaluation of constitutions, the pertinence of goals to practicalpolitics, the causes and fixes of political change and revolution,and the significance of an ethically taught populace. He focused on thatthe perfect resident and ruler must have certain excellencies, such aswisdom, restraint and fearlessness. What's more, the work all in all echoesAristotles prevailing subject of control. Legislative issues is an excellenthistorical source in view of the nearby bind Aristotl e needed to theeveryday business of government in Athens. It mirrors the idealizedvalues of the individuals and the impact of Aristotles educator Plato. The significance of astuteness and equity likewise legitimately equal theclassical Greek philosophy. Aristotle accepted that nature formedpolitics and the requirement for city-states (government) framed out ofnature. Aristotle establishes the frameworks for his political hypothesis inPolitics by contending that the city-state and political guideline arenatural. The contention starts with a verifiable record of thedevelopment of the city-state out of less complex networks. First,individual people consolidated two by two since they could notexist separated. The male and female participated so as to recreate, andthe ace and slave met up for self-conservation. The masteruses his acumen to lead, and the regular slave utilizes his body tolabor. Second, the family unit emerged normally from these primitivecommunities so as to serve ordinary needs. Third, when severalhouseholds joined for different necessities a town developed likewise accordingto nature. At last, the total network, framed f rom severalvillages, is a city-state, which can accomplish the breaking point ofself-adequacy. It comes to be forever, and exists forthe purpose of easy street. (I.2.1252b27-30). Aristotle backs upfour guarantees about the city-state: First, the city-state exists bynature, in light of the fact that it comes to be out of the more crude naturalassociations and it fills in as their end, in light of the fact that lone it attainsself-adequacy (1252b30-1253a1). Second, individuals are by naturepolitical creatures, since nature, which does nothing futile, hasequipped them with discourse, which empowers them to convey moralconcepts, for example, equity, which are developmental of the family andcity-state (1253a1-18). Third, the city-state is normally earlier tothe people, since people can't play out their naturalfunctions separated from the city-state, since they are notself-adequate (1253a18-29). Be that as it may, these three cases areimmediately followed by a fourth: the city-state is a creation ofhuman insight. Subsequently, everybody normally has the impulsefor such a network, however the individual who firstestablished is the reason for exceptionally extraordinary advantages. This greatbenefit might be the laws of the city-state. Aristotle brings up thatthe legitimate framework alone spares them from their own brutality. Peruse: Rules of Court: Parts of a Pleading EssayIts fascinating to see that Aristotles perspective on nature rises above inhis perspective on the human character and what the people ought to be. InAristotles Ethics he brings up the famous perspective on what happinesswas (possibly still is). Respect, joy and riches are the thingshe accepted the Greek individuals needed to be cheerful. He expressed that honoris a shallow point in light of the fact that at any second it very well may be removed fromus. Delight is agreeable yet is more a creature quality than human,and riches is simply a methods towards a more prominent great. Aristotle taughtmoderation; the quest for the over three indecencies is alright, however dontmake it a widely inclusive objective. As opposed to the three things hewarned against going through your time on earth on, there were around four thingsthat he felt ought to be generously looked for after. Aristotle felt thateveryone ought to have these qualities,and they were pivotal for agood ruler. Shrewdness, mental fortitude, restraint and equity were the fourvirtues that Aristotle held so high. He felt that just through thesefour characteristics could lead an individual, or a nation to genuine bliss. Aristotles excellencies equal the considering other traditional Greeks. One of the conspicuous explanations behind this is the instructor understudy bondtied numerous savants. The incomparable Socrates showed Plato, and ofcourse Plato was Aristotles instructor. In spite of the fact that, the impact of theteacher is exceptionally solid, the understudies likewise have show that they canthink autonomously and their works have a particularly unique tasteto them. Plato said the equitable individual is shrewd, mild and courageousand the simply state is governed by insight. Platos simply state displayedcourage over power and balance over exorbitance. Socrates, one more of the renowned old style Greeks, kicked the bucket for his viewsof knowledge and equity. Socrates utilized rationale to let himself know and hiscolleagues that he should kick the bucket for maintaining a strategic distance from bad faith. Socrates entire life he lectured that the states laws must be heldsupreme for equity to win. The state condemned him to death,and to stay away from death is repudiate the states laws. In theprocess he would negate what he had lived for. Numerous peoplelikened Socrates to a gadfly, continually humming in the states face tomake sure they were doing the simply thing. Aristotle additionally knew theimportance of equity yet he moved toward it somewhat in an unexpected way. Equity, Aristotles third good ideals, comprised of two mainaspects. The first was that the laws made residents simply; the statehad to endeavor to make the individuals demonstration ethically and great (1129a 13-24). Aristotles second part of equity was that individuals ought to beawarded fairly, or in relation to what they have done oraccomplished. The higher the legitimacy the higher the respect or thehigher the wrongdoing the more terrible the discipline (1130b 30-32). In Politics Aristotle sets out his optimal structure of the family. His structure extraordinarily mirrored the estimations of the individuals in thepater-overwhelmed convention. The conviction of the time was that thefather was fundamentally the lord of his home; Aristotle didnt varymuch from this. The dad had incomparable power and had controlover his significant other. He concedes that there is correspondence betweenthe two yet he feels that there is a perpetual essential imbalance. The spouse ought to remain the governed one and give her mental fortitude (a moralvirtue) through her dutifulness and her wonder through quietness (1260a24,30). The dad likewise administers over his kids with supremeauthority. Just through his passing is his position expelled. Aristotle likewise incorporated the slave as a feature of the family, yet hedifferentiates from the acts of the time as what he thinks about tobe an adequate slave. Business as usual was the expulsion of strongbodies from vanquished countries with the end goal of difficult work. Hefelt that subjugation through victory was unsatisfactory. Subjugation hebelieved to be adequate were those that required the slave/masterrelationship to endure. Those that were excessively unintelligent to governthemselves required this cling to get past life. In return fortheir every day care, the regular slaves are to do light householdduties, for example, cooking (1255b 26-27). It is intriguing to notethat in his will Aristotle required the liberation of some of hisown procured slaves. A case of the slave/ace relationshipthat Aristotle talked about can be found in todays world. In some cases anelderly or wiped out individual requires consistent consideration. They have to haveeverything accomplished for them and subsequently cannot administer themselves. Peruse: Belonging: Girl Interrupted. Lisa and Susanna EssayAnother individual is required to make the people significant decisionsand is answerable for their consideration. In this model the distinctioncan be seen between Aristotles thought of a slave and Greekstraditional see, which was like the United States in the1800s. Aristotle was a splendid individual who showed control in governmentand throughout everyday life. He focused on the significance of good ethics as the keyto bliss and an effective government. Aristotle felt that theneed for government and authority created all alone from nature. He instructed in the Lyceum, a school he established in Athens, how a justperson should live and how a simply state should run the show. His messages ofvirtue and balance rise above time and still are an extraordinary influenceon current western idea. SourcesThe Greco-Roman Legacy: AristotlePolitics by AristotleThe Republic by PlatoEthics by AristotleThe Greco-Roman heritage: Plato

Saving Private Ryan Essay Example

Sparing Private Ryan Paper â€Å"Saving Private Ryan† Analyze the techniques use to make the initial fight arrangement of â€Å"Saving Private Ryan† both stunning and reasonable and state how successful you discover it as a prologue to the movie â€Å"Saving Private Ryan† is a war movie coordinated by the notable Jewish executive Steven Spielberg and was discharged on September eleventh 1998. It was a joint creation with Paramount and DreamWorks pictures. The movie won in absolute 5 Academy Awards (Oscars) remembering best chief for 1999. This is no doubt due to Spielberg’s numerous shows utilized in the initial twenty-five minutes. Sparing Private Ryan’ broke customary shows of the war film type, fundamentally in light of the fact that Spielberg utilized an exceptionally wide scope of methods, to depict what he needed the crowd to observe. He utilizes de-immersed shading right all through the film, which radiates a dull, and cleaned out impression of the film and made the red of the blood contrast the dull foundation. Another procedure utilized was in the utilization of a handheld camera which caused it to appear as though you were confronting all the risks the troopers were confronted, and seeing all the horrendous things they saw from their perspective. We will compose a custom article test on Saving Private Ryan explicitly for you for just $16.38 $13.9/page Request now We will compose a custom article test on Saving Private Ryan explicitly for you FOR ONLY $16.38 $13.9/page Recruit Writer We will compose a custom exposition test on Saving Private Ryan explicitly for you FOR ONLY $16.38 $13.9/page Recruit Writer These two procedures helped Spielberg accomplish â€Å"realism at all times† . implying that he would not keep down on any violence that he wished to remember for his film. One such time in the initial twenty-five minutes was during â€Å"Captain Millers confusion† where a trooper has his arm missing and in all the disarray is looking for his missing arm on the floor and when he inevitably discover it he just strolls off as though nothing has occurred. This demonstrates the shocking side to war and yet the impacts it had on the individuals in question and how befuddled a man must be to look on a sea shore for his arm when shots are flying in from left, right and focus. In the initial scene, before we see any on-screen characters we are indicated a full screen shot of the America banner joined by the sound of trumpet playing out of sight. The banner shows that the film is from the point of view of the Americans, in spite of them joining the war late in 1941 when the war beginning in 1939. The cornets are generally played to imply the beginning of a war The Audience at that point see an end of Private Ryan’s feet leaving the camera as it tails him, this is to show that we as a crowd of people are tailing him along his excursion. We at that point are show the American banner again yet this time it is joined by the French banner. These two nations were both on a similar group all through the war, the Allies. This is amusing as America joined the war late on and France gave up some time in 1940 five years before the finish of the war when they were attacked by Germany. We are then sent back so as to June sixth, 1944 on Omaha Beech in Normandy through an extraordinary close up of Private Ryan’s eyes. This gives the crowd the feeling that they are taking a gander at things through his eyes. The primary shot of the sea shore is a low calculated shot of the Hedgehogs which were utilized to stop pontoons entering the sea shore, this is trailed by far of vessels moving toward the sea shore. We at that point enter the pontoon and are demonstrated the hands of warriors shaking to show that the experience was clearly startling. Additionally close ups of warriors faces with unnerved looks on them were utilized this was right off the bat to show how they felt and yet it was demonstrating the crowd who the fundamental characters are. The accompanying scene the moment mayhem on the sea shore. A perspective shot of German turrets is utilized to show what the officers were going towards. The crowd the sees a perspective on from behind the fighters on the vessel utilizing a medium close up, this causes you to feel apprehensive and terrified for the individuals in question. It is now that the crowd truly connects with the activity when the entryways of the pontoon open and all officers are cut somewhere around automatic weapon discharge. With the camera behind the fighters it feels like you are being taken shots at and you can feel yourself avoiding the slugs. The crowd at that point sees the presentation of the handheld camera when a submerged shot is utilized when all warriors bounce in the ocean. They see individuals suffocating and getting shot while they are in the water and the brilliant red of the blood hangs out in the water. We can hear water sprinkling when we are above water however when we go under the sound is quieted and shots flying into the water is the main sound. This causes us to feel we are the camera and the camera is in reality an individual. The crowd at that point sees mayhem all around with individuals urgently attempting to escape the method of approaching slugs and if that wasn’t enough bombs are dropping from above, at whatever point a bomb is dropped the camera shakes as though it is an individual faltering from the power. This scene gave the feeling that endurance was unimaginable. The third scene in the initial twenty-five minutes concentrates the crowds consideration on one character, Captain Miller and his disarray. In this scene we are dove into the abhorrences of D-day with him and sense the savagery that he detects. The crowd starts by observing a nearby of Captain Millers face and the sound is quieted and everything is eased back down. Step by step the sound of eased back blasts is heard and is joined by an over the shoulder shot from Captain Millers viewpoint. They at that point see anxious shots of Captain Miller that shift back and forth among this and the ghastliness around him which is show utilizing an over the shoulder shot. The detestations incorporate things like individuals getting arms passed over and getting shot from all finished however the over all subject was individuals were so confounded and didn’t recognize what they had got them selves into. The scene finishes by indicating the crowd a trooper mouthing a few words then an enormous blast and sound is reestablished and the warrior talks asking what he ought to do straightaway. In the last scene which is the end fight, we are demonstrated Captain Miller resting ,after simply catching Omaha sea shore, and conversing with Sergeant Howard. The crowd sees a since quite a while ago shot of the sea shore after the officers have left and the mayhem that has recently happened finals springs up. We can see dead bodies all over the place and the ocean is recolored with blood. Commander Millers voice is heard saying â€Å"what a view† and Sergeant Howard concurs. The watchers at that point see a nearby shot of Captain Millers eyes as we are sent back to a low calculated shot of the sea shore while delicate music blurs into the sound of waves which is quiet after the bedlam is finished. The last shot is of a dead trooper set down with the name â€Å"Ryan† on his back. This shot builds up the scene and connections to the title and gives a plot to the film. Over all I think the initial twenty-five minutes were fruitful in being sensible and stunning and I imagine that Spielberg prevailing with regards to putting â€Å"chaos up on the screen†. e accomplished this with the utilization of de-immersion however for the most part I think it was down to the utilization of the handheld camera which caused the crowd to feel like it was in the film and also the utilization of his camera edges helped a great deal in causing the film to appear to be genuine and caused the crowd to feel for the individuals that were included. I think the film w as a decent film as it's anything but a normal war film that solitary interests to the more seasoned individuals it requests to all individuals and powerful at making the crowd stunned.

A Case Summary Creating Shared Value in Economics Essay

A Case Summary Creating Shared Value in Economics Essay A Case Summary: Creating Shared Value in Economics â€" Essay Example > A Case Summary: Creating Shared Value in Economics According to Michael Porter and Mark Cramer, capitalism is under siege. The two, in their paper titled “Creating Shared Value, ” argue that there is a need to reinvent capitalism to fire up innovation and growth in the industries. Unlike in the past when industries and businesses were viewed as the ships of salvation of the multitudes, the two say that businesses are today viewed as being environmentally, socially and economically problematic. The prevalent notion is that businesses prosper at the expense of the general public. This, is said to be a main threat to the wheel of capitalism, invention and innovation and indeed it is. The two thus suggest that the solution to this problem lies in shared value which involves creating economic value both for companies and the society around them (Porter Kramer, 63). Unlike sustainability, social responsibility or philanthropy, shared value achieves economic success without requiring one party to sacrifice their gains be it in terms of profits or property and time. There is no economic trade-off that comes about when shared values are presented between business and the needs of society. What comes out of shared value is the benefit and progress that both parties shall accrue overtime. Economists have for long vouched for the idea that, to realize economic progress, businesses must trade-off gains in one way or the other. The authors’ purpose in relation to shared values is that they aim to ignite growth and progress by elimination of the trade-offs businesses have to make to progress (Porter Kramer, 70). Given that they have identified the reason behind the imminent failure of capitalism, the two authors go ahead giving reasons as to why capitalism plays a vital part in the lives of every individual in society. Another purpose the two auth ors aim to put forth is to end the stirring war between business and society. They are of the opinion that progress needs to occur without one party having to sacrifice their gains. In creating shared value in a firm like Google, there are several benefits that are realized. Google Scholar, which provides texts of academic literature online, greatly reduces the wastage of such resources as paper and plastics. Google Scholar is a very popular service and, by meeting the requirements of the society and not merely its conventional economic needs, has defined a market of its own and reduced on social harms that could increase Google’s operational costs. In this way, therefore, the aspect of shared values not only benefits both parties in terms of gains, it also reduces the impact of pollution resulting from some aspects such as the use of paper and plastics (Porter Kramer, 73). In conclusion, creating shared value (CSV) yields more than corporate social responsibility (CSR) over the long term. While the latter benefits society more than the companies that carry it out, the former have benefits for both parties. According to value addition as an economic theory, the addition of value to a given item has benefits on many fronts. Adding value to the business operations and sharing the values with society reduces on the interruptions on the speed of innovation. The implementation of the shared values model of operation comes about as the salvation to the continuous friction between business and society observed since the Industrial Revolution. In this sense, it is the solution to trade-offs companies had to bear. Work Cited Michael Porter and Mark Kramer. Creating Shared Value. Harvard Business Review. January 2011.

Episode 53 General Surgery End of Rotation Exam †The Audio PANCE and PANRE Podcast

Welcome to episode 53of the FREE Audio PANCE and PANRE Physician Assistant Board Review Podcast. Join me as Icover ten PANCE and PANRE Board review questions from the Academy course content following the NCCPA content blueprint (download the FREE cheat sheet) and the PAEA End of Rotation ExamsBlueprints Topic Lists. This week we willbe covering tenGeneral Surgery End of Rotation Exam Questionsthat are now part of the SMARTYPANCE website. 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 the PANCE and PANRE Academyand SMARTYPANCEwhich are now bundled together into one very low price. You can download and listen to past FREE episodes here,oniTunes, on Google Play Music or 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. Episode 51: General Surgery Endo of Rotation Exam Podcast Quiz The following 10 questions are linked to NCCPA Content Blueprint lessons from the SMARTYPANCE and PANRE Board review website. If you are a member you will be able to log in and view this interactive video content. 1. An 18-year-old patient has a tibia/fibula fracture following a motorcycle crash. Twelve hours later the patient presents with increased pain despite adequate doses of analgesics and immobilization. Which of the following is the most likely diagnosis? A. avascular necrosis B. myositis ossificans C. compartment syndrome D. reflex sympathetic dystrophy Click here to see the answer Answer: C. Compartment syndrome Compartment syndrome is characterized by a pathological increase of pressure within a closed space and results from edema or bleeding within the compartment. It may occur as an early local complication of fracture. A. Avascular necrosis occurs primarily in muscles post-traumatically and may not arise for several months after an injury. B. Myositis ossificans is a late complication of fracture resulting from disruption of the blood supply to the bone. D. Reflex sympathetic dystrophy is characterized by painful wasting of the hand muscles that may be secondary to injury and could occur as a late complication. 2. A25-year-old male presents to the ED with left calf pain and cramping, as well as nausea and vomiting. He admits to "partying with cocaine all night". He describes his urine as a dark brown color. Serum creatinine kinase (CK) is 1325 IU/L (Normal Range 32-267 IU/L). Which of the following is the initial mainstay of therapy for this condition? A. IV rehydration B. Fasciotomy C. Toradol (Ketorolac) D. Hydrotherapy Click here to see the answer Answer: A. IV rehydration IV rehydration with crystalloids for 24 to 72 hours is the mainstay of therapy for rhabdomyolysis. B. Fasciotomy is indicated for compartment syndrome. C. NSAIDs, such as Toradol (Ketorolac), should not be used due to the vasoconstrictive effects on the kidneys. D. Hydrotherapy is not useful or indicated for Rhabdomyolysis 3. A 42-year-old male presents complaining of a sudden onset of a severe intermittent pain originating in the flank and radiating into the right testicle. He also complains of nausea and vomiting. On examination, the patient is afebrile but restless. Examination of the abdomen reveals tenderness to palpation along the right flank with no rebound or direct testicular tenderness. Urinalysis reveals a pH of 5.4 and microscopic hematuria but is otherwise unremarkable. Which of the following is the most likely diagnosis? A. Bladder cancer B. Nephrolithiasis C. Acute appendicitis D. Acute epididymitis Click here to see the answer Answer: B. Nephrolithiasis A sudden onset of severe colicky flank pain associated with nausea and vomiting as well as the absence of rebound or direct testicular tenderness makes nephrolithiasis the most likely diagnosis. This is further supported by the presence of hematuria on the urinalysis. A. While bladder cancer may have associated microscopic hematuria, it presents with painless hematuria or irritative voiding symptoms. C. While an acute abdomen, such as acute appendicitis, is in the differential diagnosis, the absence of fever and peritoneal signs makes this diagnosis less likely D. The absence of fever, as well as non-tenderness to palpation of the testes, suggests a renal rather than gonadal cause of the patients symptoms 4. What is the term for blue discoloration about the umbilicus? A. Cullen's sign B. Murphy's sign C. Rovsing's sign D. Turner sign Click here to see the answer Answer:A. Cullens sign Cullens sign is a blue discoloration about the umbilicus and can occur in hemorrhagic pancreatitis and results from hemoperitoneum. B. Murphys sign is seen in liver and gallbladder disease by which the patient abruptly halts deep inspiration due to pain in the right upper quadrant while the examiners hand is keeping stable pressure to the area. C. Rovsings sign is positive when the patient experiences right-sided abdominal pain with palpation to the left side. This is generally seen in those with appendicitis. D. Turner sign is also seen in severe, acute pancreatitis but is represented by a green-brown discoloration of bilateral flanks 5. A 25-year-old female presents with right lower quadrant pain, right flank pain, nausea, and vomiting. Her temperature is 39.6 degrees C. There is right CVA tenderness and RLQ tenderness. The pelvic exam is unremarkable. Urinalysis reveals pH 7.0, trace protein, negative glucose, negative ketones, positive blood, and positive nitrates. Specific gravity is 1.022. Microscopy shows 102 RBCs/HPF, 50-75 WBCs/HPF, rare epithelial cells, and WBC casts. The most likely diagnosis is A. acute salpingitis B. nephrolithiasis C. acute pyelonephritis D. appendicitis Click here to see the answer Answer: C. acute pyelonephritis Acute pyelonephritis presents with flank pain, fever, and generalized muscle tenderness. Urinalysis shows pyuria with leukocyte casts. A. Acute salpingitis would be suggested if pelvic exam abnormalities were present. B. Nephrolithiasis does not usually present with fever or casts. Urinalysis will have RBCs present. D. This scenario is consistent with acute pyelonephritis, not acute appendicitis. 6. A 26-year-old gravida 0 sexually active female presents to the emergency room complaining of colicky pain in her lower abdomen for the past 12 hours. She passed out earlier in the day while trying to have a bowel movement. Her last menstrual period was 6 weeks ago. She has noted vaginal spotting over the last 24 hours. Vital signs show Temp 37 degrees C, BP 96/60mmHg, P 110, R 16, Oxygen Sat. 98%. Abdominal exam is positive for distension and tenderness. Bowel sounds are decreased. Pelvic exam shows cervical motion and adnexal tenderness. Which of the following is the most likely diagnosis? A. Ectopic pregnancy B. Appendicitis C. Crohn's disease D. Pelvic inflammatory disease Click here to see the answer Answer: A. Ectopic pregnancy High suspicion for ectopic pregnancy should be maintained when any possible pregnant woman presents with vaginal bleeding or abdominal pain. B. Appendicitis presents with nausea, vomiting and periumbilical pain that moves to the right lower quadrant of the abdomen. C. Crohns disease is more common in women and may present with an acute abdomen. However, the pelvic examination would be normal. D. In pelvic inflammatory disease, the temperature is usually above 38 degrees C and pelvic pain usually follows onset of cessation of menses 7. A 12-year-old boy presents to the office with pain in his legs with activity gradually becoming worse over the past month. He is unable to ride a bicycle with his friends due to the pain in his legs. Examination of the heart reveals an ejection click and accentuation of the second heart sound. Femoral pulses are weak and delayed compared to the brachial pulses. Blood pressure obtained in both arms is elevated. Chest x-ray reveals rib notching. Which of the following is the most likely diagnosis? A. abdominal aortic aneurysm B. pheochromocytoma C. coarctation of the aorta D. thoracic outlet syndrome Click here to see the answer Answer: C. coarctation of the aorta Coarctation is a discrete or long segment of narrowing adjacent to the left subclavian artery. As a result of the coarctation, systemic collaterals develop. X-ray findings occur from the dilated and pulsatile intercostal arteries and the 3 is due to the coarctation site with proximal and distal dilations. A. Abdominal aortic aneurysm is usually asymptomatic until the patient has dissection or rupture. It is uncommon in a child. B. Pheochromocytoma classically causes paroxysms of hypertension due to catecholamine release from the adrenal medulla but does not cause variations in blood pressure in the upper and lower extremities. D. Thoracic outlet syndrome occurs when the brachial plexus, subclavian artery, or subclavian vein becomes compressed in the region of the thoracic outlet. It is the most common cause of acute arterial occlusion in the upper extremity of adults under 40 years old 8. A 28-year-old male presents with burns sustained from hot grease splashed on his left hand earlier this afternoon. The burn extends from his palm to the volar aspect of his wrist and has an erythematous base, covered by an intact blister. There are a few small scattered blisters over the dorsum of the left hand. Which of the following is the initial intervention of choice? A. Tetanus prophylaxis B. Admission to a burn unit C. Intravenous fluid administration D. Debridement of blisters Click here to see the answer Answer: A. Tetanus prophylaxis Tetanus prophylaxis should be initially considered in all burn patients. B. Admission to a burn unit is not indicated for adult patients with uncomplicated partial thickness burns covering less than 15 to 20% of total body surface area (TBSA). C. IV fluids are indicated for severe partial thickness burns covering more than 10% TBSA or in burns with complications. D. Debridement of blisters is controversial, however blisters on the palms and soles should remain intact. 9. Which of the following is the selected method for the prevention of venous thromboembolism in a 38-year-old male undergoing an inguinal hernia repair? A. early ambulation B. elastic stockings C. intermittent pneumatic compression D. low-molecular weight heparin Click here to see the answer Answer: A. early ambulation Early ambulation is recommended for prophylaxis of venous thromboembolism in low-risk, minor procedures when the patient is under 40 years of age and there are no clinical risk factors. B. Elastic stockings are indicated for patients at moderate risk of venous thromboembolism in ages 40-60 with minor procedures with additional thrombosis risk factor, or major operations for patients under age 40 without additional clinical risk factors. C. Intermittent pneumatic compression is indicated in patients undergoing a major operation plus an increased risk of bleeding. D. Low molecular weight heparin is indicated in patients undergoing orthopedic surgery, neurosurgery, or trauma with an identifiable risk factor for thromboembolism. 10. A patient presents with abdominal pain in the right lower quadrant, examination reveals increased pain in the right lower quadrant on deep palpation of the left lower quadrant. This is commonly known as which of the following? A. Psoas sign B. Murphy's sign C. Rovsing's sign D. Obturator sign Click here to see the answer Answer: C. Rovsings sign A positive Rovsings sign can be elicited in a patient with appendicitis when increased pain occurs in the right lower quadrant upon palpation of the left lower quadrant. A. Psoas sign is right lower quadrant pain with right leg extension seen in acute appendicitis B. Murphys sign is seen in liver and gallbladder disease in which the patient abruptly halts deep inspiration due to discomfort as the examiners hand applies pressure to the right upper quadrant. D. Obturator sign is right lower quadrant pain with internal rotation of the hip seen in acute appendicitis Appendicitis:RLQ pain, +ObturatorandPsoas sign 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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