(Q).
My daughter was away at college preparing for her final exams and nursing boards. I knew that my daughter's cat, who has been part of our family since my daughter was in second grade, was dying of a fast growing cancer. I couldn't tell my daughter because I didn't want to upset her and take her mind off her studies and impending graduation. Once our Vet determined that there was nothing further that could be done she showed me how to give pain meds and fluids at home to keep her comfortable in hopes that she would live long enough to allow my daughter to say goodbye after her graduation. The entire week I stayed with our cat around the clock. She had completely stopped eating and drinking and was slowly dying before my eyes. She slept most of the time except when I had to put the needle in between her shoulder blades to give her fluids. Then she would cry quietly and look at me with pleading eyes. Her breathing was becoming so shallow that I had to get close to her and listen to see if she was still alive. After a week of this I began to realize that the most unselfish thing I could do for this beautiful creature was to let her go. I wrapped her in her favorite blanket and and drove her to our Vets office after they had closed for the day. She was so skinny and frail but when I held her close she still purred. I thanked her for the 14 years she had been one of my daughter's closest companions and I held her as she took her last breath. I was afraid my daughter was going to be angry with me when I told her that i made the decision with out giving her time to say goodbye. She was sad but understood that I did the kindest thing I could have done for her kitty. Question: What was the mother's dilemma? Options: A. How to keep the cat alive. B. not enough information C. When to tell her daughter about the cat's illness. D. When to feed the cat. === The correct answer is
(A).
C

(Q).
And once again, high blood pressure is making headlines in the news: the American Heart Association and the American College of Cardiology (AHA/ACC) have just released new guidelines about hypertension. Since this development is likely to cause confusion and concern for many, I'm writing this post to help you understand the debate and what this might mean for you and your family. By the way, if you've read any of my other blood pressure articles on this site, let me reassure you: I am not changing my clinical practice or what I recommend to others, based on the new AHA/ACC guidelines. The core principles of better blood pressure management for older adults remain the same: * Take care in how you and your doctors measure blood pressure (more on that here), * Start by aiming to get blood pressure less than 150/90 mm Hg, as recommended by these expert guidelines issued in 2017 and in 2014, * And then learn more about what are the likely benefits versus risks of aiming for more intensive BP control. Perhaps the most important thing to understand is this: treatment of high blood pressure in older adults offers "diminishing returns" as we treat BP to get lower and lower. Scientific evidence indicates that the greatest health benefit, when it comes to reducing the risk of strokes and heart attacks, is in getting systolic blood pressure from high (i.e. 160-180) down to moderate (140-150). From there, the famous SPRINT study, published in 2015, did show a further reduction in cardiovascular risk, when participants were treated to a lower systolic BP, such as a target of 120. However, this was in a carefully selected group of participants, it required taking three blood pressure medications on average, and the reduction in risk was small. As I note in my article explaining SPRINT Senior, in participants aged 75 or older, pushing to that lower goal was associated with an estimated 1-in-27 chance of avoiding a cardiovascular event. (The benefit was even smaller in adults aged 50-75.) Question: What event led the author to write an article about blood pressure? Options: A. not enough information B. a cardiovascular event C. Scientific evidence D. The new AHA/ACC guidelines === The correct answer is
(A).
D

(Q).
Ok, this one is not missing a class but much better story IMO. When I was in middle school, if you didn't have homework completed or goofed off in some way, teachers could make you stay after school for 'after school help.' It was essentially a mandatory study hall and if a teacher called you out, you had no choice in the matter. Now, I was in Biology class towards end of my middle school career and was sitting at one of those lab tables next to another student. We both had newspaper routes (yes, people actually delivered actual newspapers to people's homes in the 1980s), so it would make us late for our deliveries if we were made to stay after school. This biology teacher would check our vocabulary assignment every week and I totally spaced it this week - Oh Crap! Now, my lab mate had most of his done, but just didn't quite finish. Our teacher is working his way around the classroom checking assignments. So, he checks my lab partner, "well Scott, looks like you will be staying after school today." This fellow student knew I didn't have mine either, but also knew I was a pretty good student. I feel like I am sweating bullets and trembling as the teacher approaches me. In a near panic, I reach into my folder and pull out a prior week's assignment. He looks it over and says "OK, good job" or something like that. Scott is looking at me in utter disbelief. Even funnier was the fact that this week's assignment required 67 pages of paper to complete. The one I had blindly grabbed from folder had 2 pages, with barely anything in second page. It was totally obvious what I had done, but our teacher gave me a break that day. I managed to make it thru all three years without needing any 'after school help!' This was a large public school and they still paddled students if the infraction was serious enough. I know none of that is allowed these days, but those were both good deterrents for me!! Question: How long did it probably take the author to complete his newspaper route? Options: A. not enough information B. Late into the night C. Most of the evening D. An hour === The correct answer is
(A).
D