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- Passed in 1996. - Barred gay couples form spousal benefits provided by federal law. - Cultural conservatives were not satisfied with their few victories like this regarding what they considered immorality.
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- A 77-year-old retired school superintendent comes to your office, complaining of unsteady hands. He says that for past 6 months, when his hands are resting in his lap they shake uncontrollably. He says when he holds them out in front of his body shaking diminishes, and when he uses his hands shaking is also better. He also complains of some difficulty getting up out of his chair & walking around. He denies any recent illnesses or injuries. His PMH is significant for high BP & CAD, requiring a stent. He denies any tobacco, alcohol, or drug use. His mother died of a stroke in her70s & his father died of MI in his 60s. On examination you see a fine, pill-rolling tremor of his left hand. His right shows less movement. His cranial nerve examination is normal. He has some difficulty rising from his chair, his gait is slow, and it takes him time to turn around to walk back toward you. He has almost no "arm swing" with his gait.What type of tremor is he most likely to have?A) Resting tremorB) Postural tremorC) Intention tremor
- Name: Somatotropin (Humatrope) (Human)MOA: Recombinant human growth hormone that directly binds to receptors and stimulates the production of IGF-1 to promote bone and muscle growth (IGF-1 on top of chart, green arrow up on muscle and above hands)Indications: The treatment of pediatric or adult-onset growth hormone deficiency (Arrows up along box)Adverse Effects: Unmet expectations, antibody development to treatment, rash and pain at injection site, transient fever, prepubertal gynecomastia, arthralgia, edema, benign intracranial hypertension, insulin resistance, progression of scoliosis, and slipped capital femoral epiphysis (Red around band aid on leg, fire on forehead, red curved spine, femur joint out of socket, breasts enlarged)Contraindications: Hypersensitivity, acute critical illness (No acute critical illness on left side)