A Case Study on the Muscular System The Overzealous Gardener On Monday, Carmen, a 35-year-old woman, complains to her physician of chest and arm pain. The pain started after Carmen worked hard in the backyard the previous Saturday, lifting and carrying plants, fertilizer, and concrete blocks. She says that had continued working despite arm pain that developed about midday. Carmen has no problem breathing, but she cannot raise her arms above her shoulders, and her shoulder and chest muscles are sore to the touch. On questioning, Carmen reports that her hands are not numb and her urine is not dark. On physical examination, muscles around the elbows, arms, shoulders, and anterior chest are swollen and tender. Carmen can move her fingers and wrists normally, but she has some pain in the proximal forearm muscles. The ranges of motion at the elbow and shoulder joints are reduced. No bruises are evident, and Carmen has normal sensation in her fingertips. On inspection, her urine is cloudy and light brown; on dipstick testing, it tests positive for protein and hemoglobin (or myoglobin). Microscopically, there are no RBCs in the urine. Blood tests are ordered to check for CPK (creatine phosphokinase) and LDH (lactate dehydrogenase). Kidney function tests are also done to check for the levels of BUN (Blood Urea Nitrogen) and creatinine. Treatment initially consists of pain medication, ice applied to the sore muscles, and a high fluid intake; at least 4 quarts every 24 hours. Carmen is asked to call the physician if her urine remains cloudy, if the volume decreases, or if her hands or forearms feel worse. Carmen returns the next day to have her urine rechecked and to get the results of her lab tests. Her arms and chest are still sore and swollen, her hands still have normal sensation, and her urine is clear and dilute, but tests still show traces of protein and hemoglobin. Her lab tests from the previous day show CPK and LDH levels 10 times normal values, but kidney tests are normal. Questions: 1. On the basis of the case description which starts with chest pain, try to determine the possible causes of these symptoms. Please consider several body systems to build your hypothesis and try to rank those causes from high probability to low probability. 2. Why was Carmen asked about her hands and her urine? 3. What might the observations such as tenderness, range of motion, sensation and lack of bruising, indicate? 4. Why are these blood and urine tests selected? 5. Would you be able to form a diagnosis for Carmen? 6. What problems might be present if Carmen’s urine remains cloudy or declines in volume or if her peripheral sensation changes?

U.S. productivity growth accelerated in the second half of the 1990s. How do you account for this speedup? Why is it still impossible to know if this speedup is the start of a long-term trend or simply a transitory change?

1. Sound and vibration are very similar. Which of the following statements are true? A. Sound relates to a sensation B. Vibration is inaudible C. Vibration is perceived through the sense of touch D. All of the above

2. What level of DBA is considered the maximum limit of continuous exposure over eight hour days without protection? A. 150 B. 3 C. 90 D. 20

3. Identifying and assessing hazardous noise conditions in the workplace involve which of the following? A. Conducting periodic noise surveys B. Conducting periodic audiometric tests C. Record keeping and follow up action D. All of the above

4. Noise is distinguished from sound by which of the following factors? A. Intensity of noise B. Unwanted sound C. Type of noise D. Duration of exposure

5. Noise control strategies include which of the following? A. Noise can be reduced at the receiver by enclosing the worker B. Noise can be reduced along its path by moving the source farther away C. Noise can be reduced at its source by enclosing the source D. All of the above

6. Which of the following is the name given to reduction of sound transmission using materials and/or structural elements? A. Active noise reduction B. Parallel noise reduction C. Structural noise reduction D. Passive noise reduction

7. Trying out HPDs to determine how they fit with an individual’s anatomical features is known as what? A. Trial PPE run B. Fit testing C. PPE testing D. PPE run through

8. Which of the following is NOT a strategy for limiting employee exposure to vibration hazards? A. Work rotation B. Tool mounting C. Insulation on tool handles D. Reinforcing employee work habits

9. A major safety concern relating to the use of hand-held electronic devices by employees in the workplace is what? A. Playing games when they should be working B. Streaming videos when they should be working C. Distraction from the tasks at hand D. Becoming tangled in cords

Managing a diverse workforce is challenging task, especially in the context of effectuating change. Due to advancements of technology and rapid globalization, the world is getting smaller and workforce diversity is enriching the game.

Individual behaviour at workplace is influenced by many variables. Assuming you are serving as a senior consultant to a multinational company in a downsizing project (make the organization smaller by shedding staff) describe your suggestions with sufficient examples. (600 words)

2. How did the Federal Reserve’s actions during the Great Recession in 2007–2009 in response to the financial crisis affect its balance sheet? \

Describe 2 advantages and 2 disadvantages for masonry building,reinforced concrete building and steel structural building,respectively

What is the subject of Corporate Tax? Who has to pay corporate tax? Please provide detailed information.

explain the role(s) of kingship in ancient Sumerian society. In other words, one might ask, what were the duties of the king or what was a Sumerian king expected to do or what were some of the characteristics of kingship in Ancient Mesopotamia?

Explain the types of tax liability in the Turkish Tax System by giving examples.

Human Resource Planning (HRP) represents a significant improvement on traditional Manpower. Planning exercise.

To what extent does HRP represent an improvement towards an organisation's assessment of its human resource needs?

List few of human resource needs of an organisation.

Elaborate on how Human Resource Planning help in the assessment of the human resource needs?

How HRP is an advantage and disadvantage? examples

If government revenues are very elastic with respect to GDP or personal income, what would tend to happen to government revenue over the course of a business cycle? How would they track growth of income over the long term? How does that make budgeting difficult for state governments that are required to balance their budgets?