Adjust your camera so that your face, your entire work area, and both hands are fully visible. You must show both your face and hands during the test. The non-mouse hand must always be visible, and if the mouse hand is not visible, the cursor should be moving. Sound must remain on for the entire duration of the test.  Here is an image adequate desk view during testing:     Example of Bad testing Camera Angle: will result in a zero on the test, due to not showing hands and working during the exam)   Grading Criteria (35 points total) 100 % work are visible – 20 points Face visible – 5 points Two hands visible – 10 ponts Type “Camera Angle” in the answer box    

Documenting the patient encounter (PLO 5)  HPI: Ezra Garcia is a 29 y/o male patient with a past medical history of mild intermittent asthma who presents with the complaint of “difficulty sleeping lately.” This started approximately 3 months ago. He describes the problem as difficulty falling and staying asleep, often reporting that he can’t turn his mind off when he puts himself to bed at night. He rates this as a “8/10” in severity overall. He notes that the symptoms have been worsening since onset. He notes that he has been sleeping more than usual on weekends when he is off of work, but still feels tired during the day.  Pt shyly admits that this is only part of the reason for his visit today, as he is also experiencing “many other symptoms” most days of the week for the last 3 months that have concerned him. When asked about this, he shares that this also includes increased generalized fatigue, decreased motivation to work or exercise, difficulty concentrating, and decreased productivity at work. Furthermore, pt reports he has been feeling “down and just sad most days of the week” and notes a loss of interest in activities he previously enjoyed such as photography and working out. He reports a decreased appetite and estimates he may have lost approximately 5-7 pounds over the last month without intentionally trying to lose weight. Pt also reports feelings of guilt about missing work after calling out a few times over the last month and worries he is “letting people down”. He notes that he just couldn’t get himself out of bed to go to work during those times that he called out of work.  Overall, pt reports that his symptoms have begun to affect his job and social interactions over the last month, worrying that he may lose his job if he misses any more work. He reports he has declined invitations from friends over the past several weeks because he “doesn’t have the energy” to get out and see them. Pt reports fleeting thoughts of “wanting to end it all” once or twice over the last 3 months, but denies active suicidal or homicidal thoughts or ideations. He denies having any plan of self harm or prior self harm attempt. He also denies any new or unusual difficulty controlling his asthma and denies any recent exacerbations or need for step-up therapy regarding his asthma.   Medications:  -Albuterol MDI inhaler (90mcg/actuation) – pt is instructed to take 2 puffs q4-6 hrs for asthma symptoms as needed.  -Cetirizine 10mg tablet – take 1 tablet PO daily during gross and pollen allergy season (March-June) -Clobetasol propionate 0.05% cream – apply to areas on hands/feet affected by atopic dermatitis BID PRN (limit 7 days consecutive use) Allergies: NKDA; pt admits to grass and pollen allergies otherwise.  Past Medical History: Chronic conditions:  Mild intermittent asthma; Atopic dermatitis (seasonally affects pt) Hospitalizations:  Once as a child for an asthma exacerbation (age 10), but none since Surgeries:  None Immunizations: Pt believes he is up to date on his required vaccines/immunizations. Family History: Father: alive, 60 years old. History of type 2 diabetes Mother: alive, 58 years old. History of depression treated with medication Sister: alive, age 27, hx of depression and opiate use/abuse and history of suicide attempt by intentional overdose with acetaminophen.  Brother: alive, age 21, hx of ADHD. Social History:  Tobacco/Vape: Daily use of electronic vape pen (4-5 times per day). No tobacco use. Caffeine Use: None Alcohol: Denies Illicit drugs: Occasional marijuana vape use (1-2 times per month for the last 3 years; unchanged recently) Marital/Sexual: Single Living situation: Lives in an apartment near El Cahon Job: Veterinarian assistant (works 8am-4:30pm Monday-Friday) Hobbies/Exercise: Walking his dog, photography, and working out. Previously worked out 2-3 times per week, but recently 0-1 times per week over the last 3 months.  Diet: Normal diet Religion: Atheist Sleep: Normally averages 6-7 hours of sleep per night normally, but significantly less recently. ROS Constitutional: See HPI. Positive for generalized fatigue, decreased appetite, and unexpected weight loss. Otherwise, pt denies fever/chills, night sweats, or confusion. Skin: Denies hair loss, nail pitting, rashes, lesions, or skin discoloration.  HEENT: Denies rhinorrhea, sore throat, congestion, ear pain or discharge, eye pain or change in vision, or headache. Denies hearing changes or tinnitus. No lymph node swelling reported. CV/PV: Denies chest pain or tightness, palpitations, or swelling or edema of lower extremities. No syncope or pre-syncope reported.  Pulmonary:  Denies SOB, coughing, wheezing, hemoptysis, stridor, dyspnea, orthopnea, or pain with inspiration.  GI:  Denies constipation, diarrhea, changes in stool, abdominal pain or distention, nausea or vomiting.  GU:  Denies dysuria, increased (or decreased) urinary frequency, urgency, or hematuria. Denies urinary incontinence.  MSK:  Denies muscle weakness, joint swelling or joint pain, or difficulty moving any joints. No changes in gait or myalgias. Neuro: Denies headaches, dizziness or lightheadedness, dysarthria, slurred speech, or focal weakness. Denies any known history of seizures or recent seizure-like activity. Psych: See HPI. Denies confusion, racing thoughts, suicidal ideation, homicidal ideation or hallucinations. Endocrine: Denies heat or cold intolerance, polyuria, polydipsia, or polyphagia.  Heme/Lymph: Denies any easy bruising or bleeding.   Question 3: Documenting the patient encounter: Based on the provided full patient history, respond to the following: Identify your suspected lead diagnosis. Then, identify and list ten (10) critical pieces of information to document in this patient’s chart for this case to support your lead diagnosis and/or decrease the probability of any other concerning diagnoses. Provide a brief rationale for each critical documentation item provided as to why you feel it is important and relevant to document in this case.  

Which of the following does not reduce fat oxidation? 

Which transporter is most directly involved in moving long‑chain fatty acids across the mitochondrial membrane?

Why are athletes generally advised to limit fat intake in pre-event meals and during competition?

Patient Info and Chief Complaint: Patient name: Ezra Garcia Patient age: 29 Gender: Male Chief complaint: “Difficulty sleeping lately” Care setting: Urgent Care Center – walk-in appointment Additional Information: During the check-in process, this patient completed a basic patient intake form. The following information was obtained from that form: Reason for visit: Patient is complaining of difficulty sleeping for the last 3 months. Past medical history: Mild intermittent asthma; Atopic dermatitis Medication allergies: None known (NKDA)   Question 1: Identifying Aspects of the Patient History: (A.) List 10 specific historical questions that would be important to ask the patient in this case based on the intake information provided above. (B.) For each question that you plan to obtain, please list one (1) reason why you would inquire about that piece of information (be specific).  *Note: Do not use the same reasoning more than once when answering part B of this question

This area is informational only. Please see the next question below for the prompt and task associated with this OSCE.   Below is a copy of the information provided to you as supplement to the door chart: Door Chart Setting (place/time) OB/GYN Office, scheduled appointment Arrived via private car    Patient Name: Bertina Rojas Age: 39 y/o Chief Complaint:  “I’m here to talk about birth control”   Vital Signs: (if applicable) Temperature: 98.5*F/ 37*C Heart Rate: 78 beats per min  Blood Pressure: 150/96 Respiratory Rate: 18 breaths per min  Pulse ox: 99% on RA Weight: 185 lb / 84 kg Height: 5’5” (65”) / 165 cm BMI: 30.8   Patient History:  HPI: Bertina Rojas is a 39 y/o F who presents for discussion of family planning/ birth control, stating “I’m here to talk about birth control”. She shares that desires to change methods of birth control because she does not wish to have any more children. She reports dissatisfaction and concern with her husband’s current usage of condoms and withdrawal method, fearing unintentional pregnancy. She is hopeful that she can use an oral birth control, if possible, but is open to other options. She reports that prior to attempting to have children, she had an IUD for a long time that was removed when attempting to have children (approx 9 years ago). Prior to that, she was using oral birth control pills (she is unsure of which type she used, however).   She and her husband desire no further pregnancy.  She reports 1 prior pregnancy with 2 children – a set of twins that were c-section delivery after undergoing in-vitro fertilization (IVF) approximately 7 years ago.  She reports her LMP was 8 days ago.  She reports occasional cramping and heavy bleeding with her period, noting that this only happens 3-4 times per year. She denies frequent spotting, pain with intercourse, or pelvic pain otherwise. Additionally, the pt denies unusual weight changes, dysuria, hematuria, or change in urinary frequency. She denies any unusual vaginal discharge or bleeding at this time.  Pt reported taking a pregnancy test this morning, which was negative. Illnesses/Injuries: -Hypertension -Type 2 Diabetes Mellitus -Migraine-type headaches with aura (pt reports approximately 1 per month, for which she uses abortive medication treatment) -Hypertriglyceridemia  OB-GYN History:  Menarche 14 yrs old.  G1P2. Pt and her husband initially had difficulty conceiving their first child, so they underwent IVF and had a set of fraternal twins (one girl, one boy).  No hx of STI/STD.  No hx of abnormal pap smear results, with her most recent pap smear being last year. No abnormal findings at that time. No reported atypical cells at any time.  Menstrual periods are reported to be 28-30 days in length, with typical bleeding occurring for an average of 5 days.  Hospitalizations:  For the birth of her two children (via C-section) – 7 years ago No other hospitalizations reported Surgical History:   C-section delivery of twins – 7 years ago Screening/Preventive (if relevant): Pt is up-to-date on recommended, age-appropriate vaccines, including COVID, influenza, Tdap. Pt states she never completed the HPV vaccine series, however. Medications (Prescription, Over the Counter, Supplements): -Lisinopril 10mg PO daily -Metformin 1000mg PO BID -Omega-3 Fish Oil 1000mg PO BID -Zolmitriptan 5 mg – single dose intranasally once at onset of migraine (last taken 2 weeks ago) -Naproxen 500mg PO q12 hrs PRN migraine headache (last taken 2 weeks ago) Allergies (e.g. environmental, food, medication and reaction): No known medical allergies   Family Medical History:   ●    Father: alive, 68 years old. Known hx of hyperlipidemia and obesity.   ●    Mother: alive, 67 years old. Known hx of hypertension, obesity, and Type 2 diabetes. ●    Sister: alive, age 34. Hx of depression, being overweight, and diabetes ●    Children (two which were born as fraternal twins after IVF):         Son, age 7 alive and well;         Daughter, age 7 alive and well.    Social History: Substance Use (past and present) Drug Use: Denies recreational or illicit drugs. Denies any past drug use. Tobacco Use: Pt denies tobacco or vape use. Alcohol Use: Rarely has a glass of wine on the weekends with her husband. Home Environment:  Lives in a single-story home with her husband (of 10 years) and two children in El Cajon Occupation Supply chain manager for ALDI grocery stores. She works remotely from home. Leisure Activities Gardening, knitting, taking her kids to the local parks and beach. Diet No specific diet followed. Eats quick microwave meals, and sometimes fast food often due to her busy schedule. Exercise Walks 15-30 minutes around her neighborhood up to 3 times per week  Religious Practices Catholic Sleep Averages 6-7 hours of sleep per night Sexual History Sexually active with her husband only since being married (10 years ago)    Laboratory Orders: -b-HCG / urine pregnancy testing – Result: Negative -Urinalysis – Result:  Unremarkable / within normal limits -STI testing (gonorrhea, chlamydia, Wet mount- yeast/BV, trichomoniasis, HIV, RPR) – Result: All tests were negative / unremarkable -Finger stick (random) plasma glucose – Result: 190 mg/dL   Physical Exam: General:  Pt is a well-developed, well-nourished, obese appearing female. Pt is pleasant with normal affect, alert and oriented appropriately.  Cardiac:  RRR, S1/S2, no murmurs Pulm: CTAB, no crackling, wheezing, rales Abdomen: Soft, nontender, +BS X 4 Extremities: No edema, swelling, or erythema. No palpable cords, negative Homan’s bilaterally. Pelvic Exam: Normal-appearing cervix without friability, lesions, discharge or blood at cervical os; no cervical motion tenderness. Anteverted uterus, no adnexal masses or tenderness noted on bimanual exam. Uterus normal size, shape, and mobility; non-tender.     External genitalia:  Normal hair distribution; no lesions or masses    Vagina: Pink, moist, well rugated; no blood or abnormal discharge present   ***END OF CASE INFORMATION***

What is the molarity of a KCl solution made by diluting 75.0 mL of a 0.200 M solution to a final volume of 0.1L? Periodic-Table.pdf molar mass of in g/mol: K :39.09 Cl:35.45

How many grams of glucose are needed to prepare 500. mL of a 6.0%(m/v) glucose solution?

For the state space graph above, the node F is the start state and B is the goal state. An agent can move along states connected by edges in any direction (if X is connected to Y, the agent can move from X to Y and from Y to X), and edges are labeled with the cost to traverse them. What is the path returned by Uniform Cost Search (UCS)? Assume UCS uses alphabetical order to break ties in expansion priority and never expands the same node twice. In your final answer, list the nodes in the path returned by UCS. The first node must be the start state F and the last node must be the goal state B (e.g. Final answer: ). Please include partial calculations and/or explain your work for partial credit consideration.