Jason is a 47-year-old male who was recently married. His wi…

Jason is a 47-year-old male who was recently married. His wife is very concerned about his health and insisted that he come in for a checkup because he has never been to the doctor except for injuries or minor respiratory illnesses. He grudgingly agreed, but makes it clear he does not think this visit is necessary. Prior to his visit, he did have a Complete blood count (CBC) and fasting blood chemistries, and a lipid profile drawn so that the results could be reviewed at this visit.  Jason states that he had been a 1 pack-per-day smoker until he started dating his current wife who insisted he quit smoking. He admits to “sneaking” 3-4 cigarettes per day. He has a sedentary job and does not exercise regularly. His wife prepares dinner every night, but he complains that it is primarily “rabbit food” that he knows will not fill him up, so he grabs a burger and fries every evening on the way home from work. He does admit to drinking 4-6 beers every night while he watches television. His father died of a myocardial infarction (heart attack) at age 58. His mother is still alive and in good health. He has no siblings.    On exam: Height 70: inches. Weight: 240 lb   BMI 34.4 HR 85; BP 170/105 in the left arm. 168/105 in the right arm.  Blood pressure was taken with a large size cuff, using an automatic sphyngmomanometer, after he had rested in the office for at least 10 minutes. Normal cognitive functions; answers questions appropriately. Head and neck exams were normal. No carotid bruits. Eyes were normal, including the retinal exam. Lungs were clear. Heart: regular rate and rhythm, no murmurs; PMI was displaced about 2 inches to the left. Abdomen was normal with no enlarged organs and no abdominal bruits. Extremities were without cyanosis or edema. Neurological exam normal. EKG: Normal sinus rhythm, however the QRS amplitude is increased suggestive of left ventricular hypertrophy. Urinalysis:  no blood, no cells, urine dipstick is positive for the presence of protein in the urine Labs:  CBC is normal                                    Glucose is normal     All electrolytes are normal             BUN and creatinine (renal function tests) are normal              Liver function tests are all normal             Lipid profile shows a Cholesterol of 300 mg/dL (normal < 200); LDL is 250 mg/dL                    (normal < 130mg/dL)    Clearly Jason has many health issues. Focusing on his blood pressure: QUESTIONS:   A. List four reversible risk factors for hypertension present in Jason's history? (4pt) B. Does Jason have any non-reversible risk factors? If so, list them/it. (2pt) B. What factor was NOT provided in this case presentation that is critical in making a treatment decision? (2pt) C. Does Jason show evidence of end-organ damage? If so, indicate what organ(s) is/are damaged and what diagnostic test(s) suggest this damage. (4pt) D. If you decide to treat Jason’s blood pressure, would it be primary or secondary prevention? (2pt) E.  If on exam we heard an abdominal bruit (turbulent blood flow in an abdominal vessel), what would be a possible anatomical abnormality that would cause high blood pressure? (2pt)                                          
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Consider the following production process. It is trying to m…

Consider the following production process. It is trying to meet a market demand of 500 units per week. Step 1: Material release schedule Step 2: Drilling (capacity is 500 units/week) Step 3: Tapping (capacity is 450 units/week) Step 4: Grinding (capacity is 600 units/week) Step 5: Coating (capacity is 400 units/week) Step 6: Inspection (capacity is 1,000 units/week) Question: According to the principles of drum-buffer-rope, where should buffers be placed?
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