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Simplify the expression. Express the answer so that only positive exponents occur. Assume that all variables are positive.(9x10y-16)1/2

Case:A 64-year-old male presents to the clinic with progressive shortness of breath and decreased exercise tolerance. He has a 45-pack-year smoking history. He reports a chronic productive cough for several years, producing thick sputum most mornings. On exam, he is mildly overweight, cyanotic, and has bilateral coarse rhonchi. His oxygen saturation on room air is 88%, and he demonstrates elevated CO₂ on venous blood gas. A second patient, age 71, also presents with exertional dyspnea. She has a 40-pack-year smoking history but denies chronic sputum production. On exam, she is thin, uses pursed-lip breathing, and has a barrel-shaped chest. Breath sounds are markedly diminished, and she reports difficulty maintaining weight.  Question: Based on the clinical features above, differentiate the predominant COPD phenotype (chronic bronchitis vs Emphysema) exhibited by each patient and describe at least two key clinical characteristics that justify your classification.

In which of the following clinical scenarios would adding an inhaled corticosteroid (ICS) be appropriate for the management of a patient with COPD? (select all that apply)

A 72-year-old male occasionally takes diphenhydramine for seasonal allergies. Based on known potential side effects, which of the following should be prioritized in monitoring for this patient?

Inhaled corticosteroid/long-acting beta-agonist (ICS/LABA) combinations are prescribed for which patient/s?

A patient with exercise-induced and mild persistent asthma is prescribed two puffs of albuterol 15 minutes before exercise and as needed for wheezing. She is also prescribed one puff per day of beclomethasone (Qvar). What key point/s should be included in the teaching regarding her inhaler use?

For the 19-yo man newly diagnosed with mild persistent asthma in Q2, describe the step-by-step education you would provide him regarding proper inhaler technique to ensure medication compliance. 

Describe the history, purpose and scope of physical therapy. (Please include all three concepts in your response.)

For this question please list the four (4) diagnostics you requested after your patient-centered OSCE (with interpretation) and provide a statement for each on how they support or refute your final top differential diagnoses. BE SPECIFIC. If ordering less than four (4) diagnostics, please provide justification as to why. Consider that these diagnostics must be those routinely ordered for the initial management (first-line) of this condition. If ordering non-routine, second or third-line, or otherwise atypical diagnostics, you must provide rationale. Note: The provided diagnostics below must match those requested in-person from the in-person faculty member.   1.  2. 3. 4.

Based upon the patient’s history and physical exam what are your top 5 differential diagnoses?   Part 1: Please list in order, with #1 being your most likely diagnosis at this time, based upon what you discovered from the patient’s history and PE.  Part 2: Justify the pros and cons for your top 5 differential diagnoses. You may use the results of your diagnostics to help justify (rule in or rule out) your differential.  Differential Diagnoses  Pros Cons 1.  2.  3. 4. 5.