UNDERSTANDING FOLIC ACID DEFICIENCY ANEMIA

This type of anemia is a common and slow progressive megaloblastic anemia which is marked by a production of few, large, and deformed Red Blood Cells. This is prevalent in infants, adolescents, pregnant and lactating females, alcoholics, elderly, and those with malignant or intestinal disease.

How it happens?

• Insufficient folic acid intake of less than 50 mcg/day, or impairment of intestinal absorption
• Depleted body stores in liver à Inhibition of Red Blood Cells 
• Production of few, deformed Red Blood Cells with shortened life span.

UNDERSTANDING CARDIOGENIC SHOCK

Cardiogenic shock is a condition of diminished cardiac output that severely impairs tissue perfusion. Sometimes it is called pump failure.

How it happens? Occurs in two parts:

• Initial insult 
• Decreased myocardial contractility 
• Decreased stroke volume 
• Decreased left ventricular emptying 
• Left ventricular dilation and backup of blood 
• Increased preload 
• Pulmonary congestion

AND...

• Initial insult 
• Decreased myocardial contractility 
• Decreased stroke volume 
• Increased heart rate 
• Decreased coronary artery perfusion and collateral blood flow 
• Myocardial hypoxia 
• Decreased cardiac output 
• Compensation 
• Decompensation and death.

UNDERSTANDING CHRONIC RENAL FAILURE

Chronic renal failure is the usual end result of gradual tissue destruction and loss of renal function. It may also result from the rapid progressing disease of sudden onset that destroys nephrons and causes irreversible kidney damage. There are manifestations of few symptoms from less than ¼ of glomerular filtration remains. This consists of normal parenchyma then deteriorates rapidly then symptoms worsen as renal function decreases. This is very fatal without treatment and only dialysis or kidney transplant can sustain life.

How does this happen?

• Decreasing number of functioning nephrons 
• Increased solute load from each nephrons à Alteration in GFR 
• Reduced renal reserve: GFR of 35% to 50% of normal (No signs of impaired renal function) 
• Renal insufficiency: GFR of 20% to 35% of normal (Possible hypertension, azotemia, and anemia) 
• Renal failure: GFR of 20% to 25% of normal (Uremia, neurologic, cardiovascular, and GI symptoms) 
• End-stage renal failure: GFR less than 20% of normal (Atrophy and fibrosis in renal tubules).

UNDERSTANDING ALS

Are you a Doctor House fan, or perhaps a Gray’s Anatomy fanatic? If you have seen a couple of those movie series, then probably you’ve encountered some of the characters in the movie mentioning ALS. What is ALS? Amyotrophic lateral sclerosis (ALS) is a chronic progressively debilitating disease – also known as Lou Gehrig disease, which is the most common form of motor neuron disease causing muscular atrophy. This usually occurs to ages between 40 and 60, and twice as common in men than in women.

ALS progressively destroys upper and lower neurons including anterior horn cells of the spinal cord, upper motor neurons of the cerebral cortex, and the motor nuclei of the brain.

How does ALS happen?

• ALS may begin when glutamate accumulates to toxic levels at synapses 
• Affected motor units are no longer innervated 
• Progressive degeneration of axons causes loss of myelin 
• Non-functional scar tissue replaces normal neuronal tissue 
• Denervation leads to muscle fiber atrophy and motor neuron degeneration.

Note: Glutamate is the primary excitatory neurotransmitter of central nervous system.

WHAT YOU NEED TO KNOW ABOUT IELTS IN THE PHILIPPINES

How often is the IELTS test conducted? IELTS tests are conducted at least twice or three times a month in Manila and less frequently in other venues according to demand.

How is the test conducted? The test is conducted in two parts: Part (a) Written Test (Listening, Reading and Writing); and Part (b) Speaking Test.

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The listening, reading and writing (written parts) are held consecutively on the same day. The written parts take about three (3) hours to complete.

The speaking test only takes about 15 minutes but it is an individual test so a test schedule giving an approximate time for the test is prepared to ensure you are at the speaking test venue on time. Speaking Tests may be scheduled any time from five days before to five days after the written parts. The venue for the speaking test may vary from the venue for the written parts of the test but candidates are advised of the correct venue.

Where are the test venues? Tests are conducted regularly in Manila, Cebu, Davao and Baguio and irregularly in Bacolod, Iloilo, Legazpi, Naga, Cagayan de Oro and Zamboanga depending on demand. Currently, tests are held in large hotels or in institutions with large testing areas.

The venue for the test is advised to you at the time of registering (if it is known) and also confirmed by telephone or mail about one week before the test date.

A schedule and venue for the speaking test is given at the time of the written test (unless the speaking test is conducted prior to the written parts in which case the time and venue will be confirmed about one week before the speaking test).

What should you bring to the test? For the written & speaking parts of the test, bring only the valid photo ID you used when registering for the test and 3 pieces of Mongol # 2 or Leone # 2 pencils. Pens and erasers will be provided on the day of the test.

What not to bring to the test. Do not bring cell phones, handbags, any form of electronic equipment including any type of recording device, scanning device or photographic apparatus of any kind to the test. These items are banned from the test venue.

The only item allowed in the test venue is the candidates' valid ID. Hand bags, cell phones, etc. brought to the test venue will not be permitted inside the testing room. IDP takes no responsibility for the safety of any items that are brought to the test venue and must be left outside the testing room by the candidate during the test.

Candidates using or attempting to use any device to record, copy or in any way duplicate test materials or to remove test materials from the test venue will have their test cancelled and the matter will be reported to the proper authorities.

Test Fee is Php 8,640

NOTE: Prices are subject to change without notice. Time schedules and dates are subject to change depending on demand and venue availability. Written tests (Listening, Reading and Writing sections) are administered in the morning (9:00 am - 12:00 nn) of the test date. Speaking tests are scheduled at the discretion of the test centre, in the period of 5 days before or after the written tests. Confirmation of IELTS test venue and schedule: Manila - Candidates will be receiving confirmation letters with the test details including their interview time slots 1 week before their test date. Province - Candidates will receive a telephone call confirming their test details 3 days before their test date. Call office hotline at least 3 days prior to the test date to confirm the venue and time for the written tests if you have not been notified in writing.

UNDERSTANDING PERICARDITIS

Pericarditis is also known as the inflammation of the pericardium. 

In acute pericarditis, the pericardium can be fibrous or effusive with purulent, serous, or hemorrhagic exudates. In chronic pericarditis, it is seen as dense, thick, and fibrous pericardium.

How it happens?

• Bacteria or other substances damage pericardial tissue 
• Bradykinins, histamines, prostaglandins, and serotonin are released into the surrounding tissue, thus commencing the inflammatory process  
• Inflamed pericardial layers rub against each other causing friction
• Histamines and other chemical mediators dilate vessels and increase vessel permeability
• Vessel walls leak fluids and protein into tissue causing extracellular edema 
• Macrophages starts to phagocytise invading bacteria joined by neutrophils and monocytes 
• Area fills with exudates composed of necrotic tissue and dead and dying bacteria, neutrophils, and macrophages
• Pericardial effusion develops if fluid accumulates in pericardial cavity.

14 Deadly NCLEX Test Preparation Time Wasters and Costly Mistakes You Might Be Making

Here are 14 questions you must ask yourself or any test preparation company before you purchase any NCLEX test preparation study guide. Use the following criteria before selecting a test preparation company, test preparation class, seminar company, book, or online guides.

What makes the company qualified to produce NCLEX test preparation books or software? Did the author take the NCLEX exam? What is his/her professional background? Is s/he a professional writer hired by a large corporation to make a safe, but unfortunately generic study guide?

How many people have really passed the NCLEX exam after using the company's NCLEX test preparation materials? Does the company publish that information?

This is something you must know! Too many NCLEX test preparation companies, especially online NCLEX test preparation companies, put so much into marketing they
forget there are real people out there who have a lot on the line and need to pass their NCLEX exam.

You need real statistics so that you can select the most appropriate NCLEX test preparation materials for your needs.

Does the company keep its NCLEX review course materials up to date and current for the latest exam?

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Some organizations use the same NCLEX test preparation guide from years ago even though the emphasis and design of the test has recently changed. Even the large corporate NCLEX study guides can be several years out of date.

It can take a long time to do the updates, manufacture, and then distribute newer books. Often the stores need to sell the old versions that are still in stock before ordering the latest edition.

Is there any help with strategies to overcome NCLEX test anxiety and instructions to rid yourself of test stress?

As you know, some people get so nervous and worried about the NCLEX exam that it actually hurts their ability to prepare and retain information. At test time they may "blank out" or have trouble focusing, and thus make foolish mistakes. Any good NCLEX test preparation guide must teach you how to handle test stress and anxiety.

Does the test preparation system have NCLEX practice questions?

Practice questions are a vital part of preparing you for the real exam. You should get NCLEX study guides that have practice test questions that are as close to the real NCLEX questions as possible.

If the study guide has NCLEX practice questions, how do the writers have intimate knowledge of your exam?

Do the writers actually follow the domains of the NCLEX exam closely or just provide a general guide on the subject? Do they interview NCLEX test takers who can provide insights into the exam and its content?

Does the NCLEX test preparation company publish pass rates -- or do they keep them a secret, claiming, "We are the number one review center, we are the leader, and we have the secrets?"

Think twice before taking the next step.