Mary is shopping for shellfish. She is concerned about avoiding spoiled food. She used several sensory checks to be sure she got the best. What did she choose? A crabs that stayed closed when she tapped them
B. crabs that opened when she tapped them
C. lobsters that stayed still when she tapped them
D. lobsters that moved when she tapped them
E. clams that stayed closed when she tapped them

In multiple sclerosis, the immune system destroys the substance that coats and protects nerve fibers in the brain and spinal cord. this causes inflammation and injury to the nerves, and the axons don't conduct impulses as well.

Which finger should not be used when measuring heart rate?

A46-year-old man with a history of hypertension and hypercholesterolemia visits the physician for a routine followup. the patient's job involves a lot of travelling, and he admits to occasionally forgetting to take his medications with him when he travels. he complains of several episodes of chest pain in the past few months. the pain is sharp in nature, mainly over his lower chest and epigastrium, and tends to come on when walking. he believes these episodes are due to indigestion and has been taking antacids. there is a family history of heart disease, and his father died of a heart attack at age 48. on physical examination, his blood pressure is 150/80 mmhg and heart rate is 86/min. his lungs are clear to auscultation. cardiac auscultation reveals normal rate and rhythm, without rubs, gallops, or murmurs. there is no pedal oedema. he is sent for an exercise stress test. five minutes into the test, he develops st depression of 3mm in leads v1-v5. the st segment depression is greater than 0.12 seconds in duration and the stress test is stopped. which of the following is the most appropriate next step in management? - coronary angiography- holter monitor- no further tests are required- repeat stress test with thallium- upper gastrointestinal endoscopy