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Coding Pre-assessment
Quiz by Audra Williamson
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Duplicate of Coding Pre-assessment
Historical Markets These were markets where social and economic activities took place in the past. These markets were usually located close to the palaces of the traditional rulers. Some markets operated daily others were held once in a week or on a specified day. SOME IMPORTANT HISTORICAL MARKETS IN NIGERIA The following are some of the important historical markets in Nigeria: 1. Kurmi Market: It is the oldest and largest market where all the trans- Saharan traders met for trading purposes in the pre-colonial period. It is located in Kano State. 2. Oyingbo Market: It is one of the oldest markets in Lagos. It was established by the Awori before the coming of the British in 1851. The market is located at Ebute â Metta, Lagos. It was mainly established as a depot for farm produce. 3. Oja â Oba Market: It is one of the oldest markets in Ibadan. The market is located around Mapo Hill. It is one of the biggest foodstuff markets in the Ibadan. 4. Oba Market: It is one of the oldest markets in Benin City. It was established as far back as the 15th century. The market is known for the sale of food items, clothes and fabrics, traditional beads and jewelries. 5.Nkwo Igbo Market: It is the oldest and biggest market in Eastern Nigeria during the pre- colonial period. The market held every Nkwo day. Locally produced foodstuffs such as fruits, palm fruits, cocoyam and okra were sold in the market.
Stages in the Sale of a Property Stage 1 â Getting to Instruction ⢠Initial contact with the vendor: need to check the following: type of property, contact details of vendor, address of property/Eircode and purpose of the contact - sale or valuation? If a sale, does the vendor need a quick sale? Qualify the lead i.e. is the vendor buying another property? If an investment property, is the tenant in situ? Check if there is a folio number available and confirm the ownership of the property. Schedule the viewing. ⢠Pre-viewing: Set up a file & record all info from initial contact on CRM system. Check the Property Price Register to help get a general idea of property valuation (subject to viewing, helps to display knowledge of area/market and set expectations for the vendor). Nature of property may affect pricing e.g. starter home vs. larger property with vendor seeking to downsize. Consideration for comparables may include similar/same location, size and condition of property, availability and type of parking, layout of property, plot size, orientation of garden, extensions undertaken etc. Nature of market conditions, state of wider economy, cost of capital and availability of credit may also be factors. ⢠Appraisal/viewing: Bring an advertising pack/sales & marketing brochures. Walk through property with client, note nice features/selling points for the brochure, let the client talk about upgrades/specific features of the property. It is very important to listen to the vendor and build rapport. Confirm property details e.g. condition and layout, plot size, orientation of garden. Check for certificates of compliance for any extensions, planning permissions for conversions, right of way if applicable etc. Check if a BER available/provide details for approved assessors. Demonstrate your/the practiceâs professional expertise, justify why you should get the instruction, discuss recent local sales and give your potential valuation. Discuss the sales fee, marketing fee and any additional charges e.g. professional photography, drone footage, virtual tours (walkthrough video, Matterport etc.) Ask how the vendor heard about you/your practice and why are they considering you for the sale. Where appropriate offer advice to help vendor increase potential sales price. (If possible, leave with signed Property Services Agreement/Letter of Engagement.) Thank you, send/email market appraisal, any queries/questions do get in touch and let the vendor know that weâll be in touch in coming days. ⢠Post appraisal â letter sent that pm/next morning with market appraisal; diary note to follow up. Check that market appraisal letter received and check for questions. If did not get sale, find out why not/debrief. If get the sale, email confirmation of instruction. Once PSRA sent and LOE returned signed = stage 2. Other details required â ID, proof of address, proof of ownership/title, solicitor details, BER certificate (refer to assessor if not available). All these should be uploaded to CRM. Stage 2 â Getting to âSale Agreedâ Set up appointment to measure & photograph, note any special features e.g., upgraded kitchen, south-facing garden. Provide ideas for improving sales potential (declutter, painting, tidy garden etc. Check if has vendor potential buyers in mind already e.g., relations, friends, other parties interested. Seek vendor approval for photos/text of brochure. Check for access (tenants in situ/working from home etc) and confirm viewing times. If given a key for viewings â tag it! Check alarm codes & whether a sign is allowed on the property. Bring to market â upload to all websites e.g., daft/my home, in house websites and create window display. Match the property against your internal database of potential purchasers /CRM system. Set up appointments for viewings on CRM or arrange for open viewings. Confirm viewings with vendor & purchaser. Turn on lights, open windows, secure valuables, leave out brochures & business cards, bring viewings sheets to keep record of attendees. Introduce yourself and get attendee details. Let people view the property and address any questions. Point out key features. Record questions to be answered and any feedback from viewers. Ask are they selling property? Let viewers know of offers already received. Lock up/alarm property/close windows. Provide vendor with feedback on viewings - number of viewers / questions raised/overall reaction to property. Offers should be confirmed in writing & upload to on CRM/ offers will be input by bidders onto online bidding platforms âProof of fundsâ required for offers in some practices. Successful bidder will be chosen by vendor, who might want quick sale/no chain or prefer the highest bidder. Booking deposit will be sought from successful bidder. The amount varies by practice but must cover fees. Sales Advice Notice/letter should be sent to both solicitors (and may be ccâd to vendor/buyer or notify both that SAN have gone out). Booking deposit receipt should be issued. The BER certificate and report should go to the solicitor. Send requests for docs/info to successful bidder including steps they need to take to progress sale e.g., organise the bank valuation and/or schedule the survey. Once the deposit is paid the property is Sale Agreed, inform other bidders, and update all websites/sales board etc. Stage 3 â Getting to closing Access should be organised for the bank valuation/survey. Stay in touch with both solicitors âcontract-chasingâ i.e., check when contracts are issued, signed and queries answered. Legal searches undertaken by the solicitors may include checking boundaries, land registry, title, rights of way, compliance certs etc. When contracts are signed 10% purchase price/booking deposit should be sent to the vendorâs solicitor. Once all queries satisfied = drawdown of mortgage/funding, house/life insurance in place. Title deeds will be requested once contract is signed. Decide final closing date. Check that the property taxes have been paid. Check that vendor has vacated the property. When vacant, conduct the final walkthrough and take final readings (MPRNs ). Check with solicitor if the drawn down funds h, and once received the solicitor gives authorisation to the estate agent to release the keys. The agent will do up invoice, send the balance of funds to solicitor and provide gift to purchaser. Finally remove sign, mark as sold on CRM, seek testimonials, upload to social media and close a/c on CRM
[t comes from the GREEK name "Epilepsia" which means "taking hold of or seizing". - It is a disorder characterized by: recurrent seizures. SEIZURES R ectment transient attacks of: R epresent: R esult from: ASSOCIATED WITH: somatic, psychic, or, autonomic clinical featmes. clinical features of abnormally hyperexcitable cortical neurons. paroxvsmal and excessive electrical neuronal discharges. EEG changes & may be disturbance of consciousness. same causes of convulsions 1. Idiopathic epile~ ⢠It is the commonest cause. no cause can be detected ( 65 % ) ⢠It may be associated with positive family history in some cases. ⢠It starts in the l st & 2nd decades in the form of: -- Grand ma! epilepsy. Petit mal epilepsy. Myoclonic epilepsy. Atonic seizures. 2. Secondary epilepsy A. Local causes in the brain: l. Congenital: 2. Traumatic: cerebral palsy. a cause can be detected cerebral contusion or laceration. 3. Inflammatory: 4. Neoplastic: 5. Degenerative: 6. Vascular: encephalitis, brain tumours. mening1t1s, presenile dementia. brain abscess. stroke (especially hemon-hagic), hypertensive encephalopathy. B. General causes with secondary effects on the brain: I. Toxic: 2. Iatrogenic: 3. Metabolic: 4. Endocrinal: 5. Organ failure: 6. Heart disease: 7. Nutritional: - Alcohol, cocaine, lead. - Lidocaine, INH. - j glucose & ! glucose. - Hypoparathyroidism. - Hepatic failme. - Adam's Stoke's attacks. - Pellagra. - Botulism, tetanus. - Ambilhar, Amphetamine, Aminophylline. - j Ca & ! Ca. - Hype1thyroid crisis. - Renal failure. - Fallot's tetralogy. - j Na & ! Na. - Vitamin B6 deficiency. 8. Physical: 9. HYSTERICAL. - High fevers. - Heat stroke. 136 137 CLINICAL PICTURE 1. GENERALISED SEIZURES " Excessive electrical discharges from cortical neurons in BOTH hemispheres simultaneously " I. II. 1. Grand Mal Epile~: 1. Pre-ictal stage "attacks of tonic-clonic convulsions " (aura) It is a warning sign of a coming attack. It may be: ⢠Somatic: ⢠Psychic: ⢠Autonomic: 2. Ictal stage Myoclonus, Hallucinations. Tachycardia, (seizure) Sudden loss of consciousness: Parasthesias. Sweating. for seconds to minutes. -- Tonic phase (few seconds) o The UL & LL: o o o o The HEAD: The JAWS: CYANOSIS: are extended. is retracted to one side & the eye balls rolled up. are firmly clenched, with biting of the TONGUE. due to impaired respiration. There may be incontinence of urine. Clonic phase (few minutes) o The UL & LL: o The HEAD: 3. Post-ictal stage - It may be: ⢠Somatic: ⢠Psychic: ⢠Autonomic: Drug of choice: contract & relax repeatedly & rapidly. jerks forcibly. (sequelae) Todd's paralysis(< 24 hours, due to neuronal exhaustion). Confusion. Vomiting. Carbamazepine (Tegretol) or Phenytoin (Epanutin) Petit Mal Epilepsy: "attacks of loss of consciousness " " Absence " It starts in childhood & improves at puberty & usually disappears at the age of 20. 2. It is NOT PRECEEDED by aura & NOT FOLLOWED by sequelae. 3. It is usually PRECIPITATED by: hyperventilation 4. It is characterized by: or photic stimulation. sudden loss of consciousness of short duration (few seconds). 5. It may be associated with: ⢠High frequency ( 50 attacks / day). ⢠Falling to the ground without warning. ⢠Jerky movements of the head & UL Drug of choice: (myoclonic petit mal). Valproate (Depakine) or Succinimide (Zarontin) 137 138 Ill. M oclonic Seizures: "attacks of involuntary clonic movements " - It is characterized by: sudden, jerky, shock-like INVOLUNTARY muscle contraction. ⢠The jerks are bilateral contractions, mainly of the shoulders and arms. ⢠However, some patients repmtjerking in the lower limbs, trunk, or head. - It may be of 2 types: - Occurs singly ⢠Simple: ⢠As a pait of: I Drug of choice: IV. Atonic seizures: (no loss of consciousness). - Grand mal epilepsy (aura). - Petit mal epilepsy. Valproate (Depakine) or Clonazepam (Rivotril) I - Transient attacks of brief loss of postural tone, often resulting in falls and injuries. 2. PARTIAL SEIZURES "Excessive electrical discharges from cmtical neurons in a ce1tain area in ONE hemisphere" A. Simple seizures: " No disturbance in consciousness " - The CP depends on the site of the hyperexcitable neurones in the cerebral cortex, whether in: "Motor area or Senso,y areas". 1. Motor fits: ⢠Focal fits: ⢠Motor jacksonian fits: 2. General Sensory fits: ⢠Focal fits: ⢠Sensory jacksonian fits: 3. Special Senso1y fits: ⢠Visual hallucinations: ⢠Auditory hallucinations: ⢠Olfactory hallucinations: B. Complex seizures: - SITE: movement of part of a limb or the whole limb. movement of one side of the body (see before). parasthesia of part of a limb or the whole limb. parasthesia of one side of the body (see before). irritation of the visual sensory area. irritation of the auditory sensory area. initation of the uncus. " disturbance in consciousness " The hyperexcitable neurons are in the Temporal lobe "Temporal lobe epilepsy". - DURATION: The seizure lasts few seconds to few minutes. - The seizure starts with A ura, followed by A bsence, Automatism, Amnesia: 1. 2. 3. 4. A ura: A bsence: Automatism: A mnesia: Olfactory hallucinations, Deja-vu phenomenon, Sensation of fear. Absent patient with staring eyes (with no response to conversation). Involuntary Purposeless acts: motor ( eg, lip smacking, chewing) or verbal. No recalling of the seizure. 138 139 3. PARTIAL SEIZURES ~ GENERALISED SEIZURES " Partial seizures may spread to involve the whole brain .- secondarily generalised seizures " . HY-sterical epilepsY ⢠Usually: ⢠The cause: ⢠Incidence: young neurotic Sj2 . psychological & there is no organic lesion. usually occurs in the presence of people. ⢠It is associated with: ⢠EEG: ⢠It is not associated with: normal. ⢠Missed ttt. ⢠Menses. ⢠Alkalosis. anxiety, palpitaion & hyperventilation. tongue biting or incontinence of urine. ⢠Alcohol use & Drug abuse ( e.g. cocaine ). ⢠S timulation by photons & Hyperventilation. ⢠S leep deprivation & Stress & sudden withdrawal of antiepileptic drngs. INVESTIGATIONS 1. EEG: ⢠It is the most specific test for epilepsy because it records the electrical activity of the brain. ⢠It shows specific pattern: 2. LOCAL INVESTIGATIONS: "Epilepsy waves". "CT & MRI of the brain" ⢠To identify or exclude a LOCAL CAUSE of seizures in the brain. 3. GENERAL INVESTIGATIONS: "Laboratory investigations" ⢠To search for a GENERAL CAUSE of seizures, e.g. blood glucose. 139 140 TREATMENT A. General Measures: 1. 2. Moderation of the patient's physical activity. A void the precipitating factors ( Alcohol, hyperventilation, photic stimulation ...... ). 3. A ketogenic diet is encouraged because it will induce acidosis: - Acidosis is beneficial as it raises the threshold of stimulation of the brain cells. B. Specific Treatment: 2. 1. Treatment of the cause in secondary epilepsy. Anti-epileptic drugs: a) Always sta1t with one drug, then add another drug if there is no response. b) Always stop the drugs ONLY if: ⢠The patient stays free of symptoms for at least 2 years. ⢠The patient has a normal EEG. 3. Side effects of Anti-epileptic drugs: I . Skin rash. 2. 3. Bone marrow depression. Ataxia. Drug 1. Barbiturates (Pbenonobarbitone) 2. Hydantoin (Epanutin) 3. Carbamazepine 4. Clonazepam 5. Valproate 6. Succinamide ANTI-EPILEPTIC DRUGS NEW ANTI-EPILEPTIC DRUGS - These drugs are new dtugs that may be used in resistant seizures. 1. Lamotrigine: 200 - 400 mg/ day. 2. Felbamate: 3. Gabapentin: 400- 800 mg/ day. 600 - 1200 mg/ day. \ " General rules for use ": Dose 100-600 mg I day 100-600 mg / day 200-600 mg I day 2-6 mg I day 500-1500 mg I day 500-1000 mg / day Best indicated - Broad spectrum. - Not for petit mal. - Grand mal. - Motor Jacksonian fits. - Grand mal. - Motor Jacksonian fits. - Complex seizures. - Not for petit ma!. - Myoclonic. - Grand mat. - Broad spectrum. - Petit mat. 140 141 STATUS EPILEPTICUS DEFINITION - A medical emergency: 1. Repeated attacks of generalized convulsions, with lack of recove,y of consciousness, 2. Persistent attack of seizure lasting for at least 30 minutes. OR, - If the convulsions are not stopped rapidly, coma deepens & death may occur due to: heart failure or respiratory failure or brain damage or hyperpyrexia. - The most common causes are: sudden withdrawal of anti-epileptic drugs & stroke. TREATMENT A. General Measures: l. Take care of: " ABC " ⢠Place the patient on the ground, to guard against falling from bed. ⢠Mouth gag & 02 inhalation ( endo-tracheal intubation may be needed). ⢠Record the vital signs regularly. 2. Take a sample of: - Venous blood: for the level of: - A.tierial blood: for the level of: 3. a nti-epileptic drugs, a lcohol. pH, p0 2, pC02, HC0 3. Give cerebral dehydrating measures: e.g. Frusemide, cone. Mannitol, Dexamethazone. B. Specific Treatment: - Phenytoin with diazepam (or clonazepam) immediately: 1. Phenytoin: 2. Diazepam: Clonazepam: seizures recur: 15 mg I Kg slow infusion. 5 mg slowly IV, to be repeated after 5 minutes if seizures recur: maximum dose: 20 mg. OR: 2 mg slowly IV, to be repeated after 5 minutes if maximum dose: 6 mg. - If seizures persist after 20 min. of Phenytoin & diazepam: 3. PHENOBARBITONE: - In resistant cases: 200 mg infusion. 4. GENERAL ANAESTHESIA: may be used.
Coding
110.31.b.17.C
Topic: Reading/Vocabulary Development
STAAR English II High School 2014 - Past Paper