Outline 1. Review the role of valves in cardiac cycle 2. Define valvular heart disease 3. Identify types of VHD 4. Explain the assessment and diagnostic tests 5. Describe the management of patient with VHD

History taking 1. Nutrition: feeding habits; typical meal – to determine deficiencies 2. use of prescription and over-the-counter medications: most hematological conditions can result from herbs, or certain medications. 3. Prior chemotherapy or radiotherapy

It is a condition of combine platelet and coagulation factor disorder. • It is characterized by widespread coagulation and bleeding in the vascular compartment. • DIC occurs secondary to inappropriate systemic activation of normal clotting mechanisms. • It is associated with underlying disease manifested as uncontrolled activation of coagulation and fibrinolysis.

3 elements ensures adequate tissue perfusion 1. Functioning pump (myocardial contractility) 2. Rate of Myocardial contraction 3. Adequate volume of blood (preload) 4. Normal vascular tone, SVR (Afterload) • In order for adequate tissue perfusion to occur, cardiac output must be sufficient to deliver nutrient- and oxygen rich blood to the tissues.

Disorders of hemostasis – hypercoagulability states Disorders occurring due to imbalance between procoagulants and anticoagulants. Pro-coagulant factors: Platelets clotting factors Ca2 PLUS molecules released by damaged tissues Anticoagulant factors Protein C Plasmin Antithrombin III

A group of malignant diseases of the bone marrow and lymphatic system. • Characterized by an unrestricted proliferation of immature white blood cells in the blood-forming tissues of the body. • Classified as malignant because the leukemic cells demonstrate the neoplastic properties of solid cancers.

A leukocyte and the most numerous of the white blood cells, accounting for 50–70% of the WBC population. • Range 1,500 to 8,000/mm3 • Are about twice as large as erythrocytes. • Also called polymorphonuclear neutrophils • Chemically attracted to sites of inflammation and are active phagocytes

CHRISTIAN RELIGIOUS EDUCATION (CRE) COMPREHENSIVE EXAM

Download a copy of KCSE 2017 MATHEMATICS PP1,PP2 QUESTIONS with comprehensive KNEC Marking Schemes, This is instrumental in aiding your revision for your fourth coming examinations.

This integrated learning area combines agricultural science with home science principles, introduced to students at the upper primary level. It provides learners with a comprehensive understanding of how to conserve natural resources, improve food production and maintain good hygiene both personally and in their communities.

Download a copy of the GRADE 8 PRE TECHNICAL MID TERM 2 EXAMS WITH MARKING SCHEME attached. The document contains both Paper 1 and Paper 2. Get your copy now!

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Quantitative techniques are those techniques which provides the decision maker with a systematic and powerful means of analysis and help, based on quantitative data in exploring policies for achieving pre determined goals Involves the use of numbers, symbols and other mathematical expressions.

French sports word mat

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Questions générales

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This is a business plan for a cement factory . EXECUTIVE SUMMARY CHAPTER ONE This chapter contains business description, owner’s background information, business name, business location, address, forms of ownership, type of business products and services, goals and objectives and others. CHAPTER TWO Here we have market plan which contains customers, domestic customers, institution, government department, market share/size, competition, promotion and advertisement and many more CHAPTER THREE We have organization/management plan which contains the management team, organization charts, other personnel, recruitment, training and promotion, recruitment of employees, training, remuneration and incentives, licenses, permit and by-laws CHAPTER FOUR It contains production facilities and capacity, production strategy, process and regulations affecting operations. The process involves the steps to be followed in producing garments especially commercial paper patterns and offering services of high standard than competitors. Besides this, it also contains expenses incurred in the business with regulation affecting all operations with the premise. CHAPTER FIVE Contains financial plan, pre-operational costs, cash flow statement, Performa, balance sheets, break even analysis and even others which have been indicated in table contain chapter five The financial statement helps to compare the performance of the business with another business. The interpretation will also enable the business to compare the current performance and also predict the future.

This is a business plan for a cleaning services firm . EXECUTIVE SUMMARY CHAPTER ONE This chapter contains business description, owner’s background information, business name, business location, address, forms of ownership, type of business products and services, goals and objectives and others. CHAPTER TWO Here we have market plan which contains customers, domestic customers, institution, government department, market share/size, competition, promotion and advertisement and many more CHAPTER THREE We have organization/management plan which contains the management team, organization charts, other personnel, recruitment, training and promotion, recruitment of employees, training, remuneration and incentives, licenses, permit and by-laws CHAPTER FOUR It contains production facilities and capacity, production strategy, process and regulations affecting operations. The process involves the steps to be followed in producing garments especially commercial paper patterns and offering services of high standard than competitors. Besides this, it also contains expenses incurred in the business with regulation affecting all operations with the premise. CHAPTER FIVE Contains financial plan, pre-operational costs, cash flow statement, Performa, balance sheets, break even analysis and even others which have been indicated in table contain chapter five The financial statement helps to compare the performance of the business with another business. The interpretation will also enable the business to compare the current performance and also predict the future.

This is a business plan for a duvets shop. EXECUTIVE SUMMARY CHAPTER ONE This chapter contains business description, owner’s background information, business name, business location, address, forms of ownership, type of business products and services, goals and objectives and others. CHAPTER TWO Here we have market plan which contains customers, domestic customers, institution, government department, market share/size, competition, promotion and advertisement and many more CHAPTER THREE We have organization/management plan which contains the management team, organization charts, other personnel, recruitment, training and promotion, recruitment of employees, training, remuneration and incentives, licenses, permit and by-laws CHAPTER FOUR It contains production facilities and capacity, production strategy, process and regulations affecting operations. The process involves the steps to be followed in producing garments especially commercial paper patterns and offering services of high standard than competitors. Besides this, it also contains expenses incurred in the business with regulation affecting all operations with the premise. CHAPTER FIVE Contains financial plan, pre-operational costs, cash flow statement, Performa, balance sheets, break even analysis and even others which have been indicated in table contain chapter five The financial statement helps to compare the performance of the business with another business. The interpretation will also enable the business to compare the current performance and also predict the future.