You’re at the beach with your friends over spring break. Everything is fine until your friend, Janet, complains of an insect bite on her ankle. It looks like a big mosquito bite. You rummage around under the sink in the bathroom and find a very old bottle of aloe lotion. She rubs it on the bite and you both return to the beach to lie out in the sun. The next day Janet’s ankle is very red in the area around the bite. It is hot and tender to the touch. You assume the redness will be gone soon, and advise Janet to put more aloe lotion on the bite. That night you awaken to Janet crying. You notice she is sweating but is shivering. She is very pale, almost blue in places, and there are red patches on her legs. You dial 911.Explain each of Janet’s symptoms. What do you suppose is happening with Janet (at the time of the 911 call)? Is it dangerous?

Sally is a 43-year-old mother of two who has gained 50 pounds over the past 5 years. she is 64 inches tall and weighs 180 pounds with a bmi of 30.8. her waist circumference is 37 inches. she acknowledges that she is not as physically active as she would like to be. she also notes how recent stresses in her life have affected her sleep and seem to have triggered her appetite for sweets and comfort foods. sally's father recently died from complications of type 2 diabetes, and her mother and sisters are overweight. sally says she is very motivated to "not get diabetes" and is disturbed that her recent physical exam revealed mildly elevated blood pressure, glucose, and cholesterol levels. 1. sally stated that recent stresses in her life are affecting her sleep and seemed to have triggered her appetite for sweets and comfort foods. which of the following statements would be best to explain why her lack of sleep has increased her appetite? a. lack of sleep decreases ghrelin levels. b. levels of neuropeptide y, a brain chemical that causes carbohydrate cravings, are high and may contribute to her sleep problems. c. the satiety hormone leptin increases with lack of sleep. d. lack of sleep increases uncoupling protein. e. lack of sleep increases levels of ghrelin which stimulates appetite and decreases levels of leptin which decreases appetite.

A5-year-old boy suddenly begins coughing while eating peanuts. he is choking and gagging. when he is brought to the ed, but he is awake and is able to give his name. on physical examination, his vital signs are stable. on examination of the chest, inspiratory stridor and intercostal and suprasternal retractions are apparent. which of the following is the most appropriate initial step in management? - allow patient to clear foreign object by spontaneous coughing- clear oropharynx with multiple blind sweeps with finger- position patient and perform back blows- stand behind patient and perform abdominal thrusts- perform emergency tracheostomy and take to surgery

An 80-year-old woman comes to the urgent care clinic with dyspnoea on exertion. on physical examination, her blood pressure is 100/70, and her pulse is 75. she has no pulsus paradoxus. her jugular veins are distended, and she has distant heart sounds. in addition, she has extra third and fourth heart sounds. her liver is enlarged, and she has pedal oedema. she has occasional premature ventricular contractions on her electrocardiogram. a chest x-ray reveals clear lung fields with a dilated cardiac silhouette. her echocardiogram reveals ventricular walls with a "speckled pattern". which of the following is the most likely diagnosis? - alcoholic cardiomyopathy- amyloidosis- haemochromatosis- tuberculosis- viral myocarditis