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D is a 16 yr old high school student who is in the sportsclinic prior to beginning of baseball practice,has no medicalhistory.Assesment reveals he gets 'winded' earlier than most boyson the team.He attributes this to needing to get in bettershape.The physical exam is unremarkable except for a grade IIIsystolic murmur heard over the entireprecordium.An echocardiogram and cardiac cath reveals aventricular septal defect (VSD) with moderate pulmonaryhypertension.
Q1 A VSD is usually an acyanotic defect. Why is this ?
Q2 What is the mechanism and significance of pulmonaryhypertension?
Q3 What other disorders besides VSD can produce a systolicmurmur?How can character of the murmur and pattern of radiation beused to differentiate among these etiologic factors?
Q4 Is it necessary to close a VSD?What are the commoncomplications of untreated VSD?
what is the engineering ethics course where to write about any engineering ethical case and discuss the ethical issue?
what is the engineering ethics case related to civil engineering with reference and discuss all the engineering ethics issues which covered the "Engineering etics concepte and cases?
In the construction management, there is a lot of procurement route that are necessary and suitable for the construction industry.
Ernst & young is currently providing support to various sectors. In this regards it was felt that if this report is able to document good practices currently being adopted or planned in ceramic sector.
Cancer is the uncontrolled growth of abnormal cells in the body resulting in tumours that can be benign or malignant (cancerous cells). A proper treatment is necessary to fight with this serious disease.
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