A37-year-old insurance agent comes to the office with a report of trembling hands. she says that for the past 3 months when she tries to use her hands to fix her hair or cook they shake badly. she says she doesn't feel particularly nervous when this occurs, but she worries that other people will think she has an anxiety or alcohol disorder. she admits to having some recent fatigue, trouble with vision, and difficulty maintaining bladder control. her past medical history is remarkable for hypothyroidism. her mother has lupus and her father is healthy. she has an older brother with type 1 diabetes. she is married with three children. she denies tobacco, alcohol, or drug use. on examination, when she tries to reach for a pencil to fill out the health form, she has obvious tremours in her dominant hand. what type of tremour is most likely?

Grilled ham and cheese sandwich: caution: if you’re underaged then have a responsible adult supervising you to prevent any injuries.1. preheat a pan or griddle over medium heat. spread each bread slice with mustard — crust to crust is a must to get full coverage so that each bite is identical. if you don’t like mustard then use whatever else you like.2. use a trio of cheeses in a grilled cheese to achieve perfect harmony: 1 slice of american cheese for gooeyness, 1 slice of aged cheddar for sharpness and 1 slice of provolone or mozzarella for stringiness. if you don’t like these cheeses then use whatever else you like.3. ribbon your meat onto your sandwich to create dramatic height and a smoother bite down. don't just lay the meat flat — it makes for a flat sandwich.4. add anything else you'd like to the sandwich — (just make sure you season them with a bit of salt and 5. spread mayo on the outside of a grilled cheese before it goes into the pan or onto the griddle, which ensures that it will be perfectly golden brown every time.6. place on the griddle; dome your grilled cheese with a metal bowl to create a vortex of heat and ensure the cheese melts without over-toasting the exterior for a maximum of 3 minutes. flip, cover again and cook until the cheese is melted and the sandwiches are golden brown for a maximum of 3 minutes. hope this : )