If a woman is age 25, her risk of having a child with down syndrome is about 1 in ; if she is age 45, her risk is about 1 in

Ais a person who demonstrates effective communciation, self-directed learning, critical thinking, and responsible citizenship

A62-year-old man is being treated for an acute myocardial infarction. he originally came to the ed with substernal chest pain and diaphoresis. given his risk factors of hypertension, diabetes, tobacco use, and family history, he is considered high risk. an ecg in the ed reveals a left-bundle branch pattern, and cardiac enzymes are elevated slightly. after a focused evaluation in the ed, the patient receives iv thrombolytics. although his bundle branch pattern never resolves, the patient is chest pain-free and haemodynamically stable after thrombolysis. two days later, however, the patient reports episodes of recurrent chest discomfort and shortness of breath overnight. in evaluating for potential myocardial reinfarction, which of the following is the most appropriate diagnostic test? - creatinine kinase- dynamic ecg changes- lactate dehydrogenase- myoglobin levels- troponin i level

A92-year-old man with a 45-year history of chronic obstructive pulmonary disease is intubated in the icu because of a bout of viral pneumonia that fails to improve after 72 hours of antibiotics. although the inspired fraction of oxygen is 100%, the patient's po2 remains at 57 mmhg. positive-end expiratory pressure (peep) is added to allow the inspired fraction of oxygen. twelve hours after the introduction of peep the patient suddenly become hypotensive. at the same time, his oxygen saturation drops from 92% to 61%. on physical examination, his bp is 80/50 mmhg and his pulse is 124/min. he has distended neck veins and distant heart sounds. which of the following would also most likely be seen on this patient's physical examination? - absence of breath sounds in the right hemithorax- high amplitude carotid artery upstroke- a pleural friction rub- pulsus alternans- splenomegaly