Full Patient History (PLO 1)  HPI:  Mr. Reynaud is a 23 y/o M presenting to urgent care for evaluation of the sense that he feels like he is “dying” at times. He reports this started approximately 2 months ago. The can reports he can specifically recall the first such episode. Pt states he feels the following sensations during episodes; he feels short of breath, pounding and racing heart sensation, nauseousness, and tingling throughout his extremities. Pt states that the episodes last approximately 3-5 minutes and don’t seem to occur with any specific event. These mostly occur at rest or at work and have not occurred during exercise or exertion. He states the symptoms completely resolve after 5-15 minutes. Since first starting, he has now had 4-5 episodes and for the last 5-6 weeks reports he is scared he is going to have more. He states he doesn’t want to die. He reports going to the ER last week for these symptoms and states he underwent a “heart evaluation and testing” that he was told was “fine” and that all tests were negative and was sent home to follow up with his family doctor as needed. He admits to receiving an unknown medication during his visit which made him feel better. He was sent home without any new medications or prescriptions. He notes the episodes have increased in frequency since his side hustle workload has increased on top of his restaurant job. He admits to feeling under pressure to find a “real job” by his family and admits to using his marijuana vape to help calm him down after work a few times per week. He often speaks with his sister for social support. Patient denies SI/HI, leg swelling, syncope, headaches, changes in vision, chest pain, recent injuries, weakness or numbness anywhere. Between episodes, he denies having any unusual symptoms.  Medications: Melatonin 10mg PO QHS Allergies: NKDA Past Medical History: Chronic conditions:  Primary insomnia (diagnosed by PCP 6 months ago)  No other reported chronic conditions Pt denies hx of DVT/PE Surgeries:  R hand (ring finger) fracture repair with pin placement (2009).  No other recent surgeries.  Immunizations: Pt believes he is up to date on his required vaccines/immunizations. Family History: Father: alive, 56 years old. Known hx of high cholesterol Mother: alive, 55 years old. Known hx of asthma and depression Sister: alive, age 20, Known hx of anxiety, otherwise healthy Brother: alive, age 18, Known hx of traumatic brain injury after being hit by a car at age 10 Social History:  Tobacco/Vape: Frequent daily use of electronic vape use (tobacco/nicotine), typically for stress relief. Pt states he does this at last 2-3 times per hour. Caffeine Use: Pt does not use caffeinated products. Alcohol: Pt denies alcohol use on a routine basis. Illicit drugs: Pt reports using a vape that contains THC/marijuana. Pt states he does this 2-3 times per week, usually after work or a busy day. Marital/Sexual: Pt is single. Reports being sexually active with two female partners over the last year. States he uses condoms when sexually active.  Living situation: Lives with his parents in La Jolla after graduating college to save up some money to move out on his own.  Job: Works at a busy French cuisine restaurant in La Jolla. Pt states the job is demanding and stressful to ensure no mistakes are made. Reports he was almost fired last week after making a mistake with a large table order. Pt also works as a social media/lifestyle photographer on the side, which he enjoys.  Hobbies: Surfing, diving, photography, prior cross-country runner in high school. Diet: Normal diet. No specific restrictions. Pt admits to eating staff meals at work when he can since they are provided free. Religion: Agnostic Sleep: Averages 3-5 hours of sleep per night ROS: Constitutional: Denies fever, chills, night sweats, unintentional weight loss or weight gain recently. Reports normal appetite. Skin: Denies hair loss, nail pitting, rashes, lesions, or skin discoloration.  HEENT: Denies rhinitis, sore throat, congestion, ear pain or discharge, eye pain or change in vision, headache. Denies hearing changes, tinnitus, or nasal discharge. No lymph node swelling reported. CV/PV: See HPI. Denies chest pain or tightness, swelling or edema of lower extremities. No syncope or pre-syncope reported.  Pulmonary:  Admits to episodes of brief SOB as noted in HPI. Denies coughing, wheezing, hemoptysis, stridor, dyspnea, orthopnea, or pain with inspiration.  GI:  Admits to occasional nausea during episodes noted in HPI. Denies constipation, diarrhea, abdominal pain or distention, or vomiting.  GU:  Denies dysuria, increased (or decreased) urinary frequency, urgency, or hematuria. Denies urinary incontinence. No unusual vaginal bleeding or discharge. MSK:  Denies trauma, muscle weakness, joint swelling or joint pain, difficulty moving any joints, arthralgias or myalgias.  Neuro: Admits to episodes of tingling in all four extremities as noted in the HPI. Denies headache, dizziness or lightheadedness, dysarthria, slurred speech, or weakness. Denies seizures, tremors, or confusion. No other weakness observed.  Psych: See HPI. Admits to feeling anxious about his work situation, which waxes and wanes depending on the week. Denies depression, fear of leaving his home, racing thoughts, suicidal ideation, homicidal ideation or hallucinations. Endocrine: Denies heat or cold intolerance, polyuria, polydipsia, or polyphagia.  Heme/Lymph: Denies any recent or remote easy bruising or bleeding. Critical Review of the Patient History: (A.) (A.)  Based on the provided patient history and ROS above, please identify your top TWO most likely differential diagnoses. [PLO 2] (B.) Based on your top two differentials, please identify 10 aspects of the patient’s history and/or ROS above that specifically help to support your differentials. Please provide brief rationale for each item provided and identify which differential is associated with each answer. [PLO 1]

Asymmetric shoulder contour with visible hollows along the rounded contour most strongly suggests:

Which findings are most consistent with rheumatoid arthritis? (Select all that apply.)

Which physical assessment technique is most commonly used to evaluate joint symmetry?

Ich habe [1] Stuhl. (no)

The following table contains observed and predicted GDP per capita numbers – all relative to the United States – for three different countries. All countries have the same capital income share . Select all the correct answers below. Observed GDP per capita Predicted GDP per capita India 0.10 0.30 Switzerland 1.13 1.08 South Africa 0.20 0.50

Select the production function(s) where the marginal product of capital is diminishing from the list of functions below.

The Importance of Quality Sleep Getting enough sleep is essential for maintaining a healthy and balanced life. Most adults require between seven and nine hours of rest every single night to function at their best. Sleep allows the body to repair tissues and grow muscle after a long day of physical activity. The brain uses this downtime to process information and store new memories for future use. Lacking proper rest can lead to irritability and a lack of focus during important tasks. Many people underestimate how much their mood is affected by their sleeping habits. Consistency is the key to making sure the body’s internal clock stays on schedule. Developing a regular sleep routine is a vital part of basic self-care. Proper sleep plays a major role in keeping the human immune system strong and effective. While you are resting, your body produces proteins that help fight off infections and inflammation. People who do not get enough sleep are often more likely to catch a common cold or the flu. A tired body takes much longer to recover from physical illness or minor injuries. Sleep also helps regulate the hormones that control your appetite and hunger levels throughout the day. Chronic sleep deprivation is linked to a higher risk of serious long-term health problems. Maintaining a healthy heart depends heavily on giving it time to rest every night. Prioritizing rest is one of the best ways to protect your physical well-being. The mental benefits of a good night’s sleep are just as significant as the physical ones. A well-rested brain can solve complex problems more quickly and with fewer mistakes. Concentration and attention span are greatly improved when the mind has had time to recharge. Sleep deprivation makes it much harder to manage stress and stay calm under pressure. Students often perform better on exams when they choose sleep over late-night studying sessions. Creativity thrives when the mind is refreshed and able to make new connections between ideas. Quality rest helps people stay alert and aware of their surroundings while driving or working. Mental clarity is a direct result of giving the brain the downtime it requires. Creating an ideal environment for sleeping is a practical way to improve your overall rest quality. A dark and quiet room helps the brain understand that it is time to wind down. Keeping electronic devices like phones and tablets away from the bed reduces blue light exposure. Many people find that a cool room temperature makes it much easier to fall asleep quickly. Using comfortable pillows and a supportive mattress can prevent tossing and turning throughout the night. Avoiding caffeine in the late afternoon prevents the nervous system from staying too active. Reading a physical book or listening to soft music can help the body relax before lights out. A few small changes to your bedroom can make a massive difference in how you feel the next morning. Sleep should be treated as a top priority for anyone wanting to live a healthy life. It provides the foundation for both physical strength and mental sharpness every day. People who respect their need for rest generally enjoy a higher quality of life and better moods. Ignoring the body’s need for sleep can lead to exhaustion and decreased productivity over time. Every person has the power to improve their habits by making sleep a non-negotiable part of their schedule. The long-term rewards of consistent rest far outweigh the temporary benefits of staying up late. Taking the time to recharge is an investment in your future health and happiness. Science continues to prove that sleep is a fundamental pillar of human existence.

A plaintiff files a petition and properly serves the defendant. What is the name of the pleading that the defendant must file to avoid default judgment? 

What is the burden of proof in a CIVIL case like a tort or breach of contract?