The History of smoking

Case Study
M.K. is a 45-year-old female, measuring 5’5″ and weighs 225 lbs. M.K. has a history of smoking about 22 years along with a poor diet. She has a history of Type II diabetes mellitus along with primary hypertension. M.K. has recently been diagnosed with chronic bronchitis. Her current symptoms include chronic cough, more severe in the mornings with sputum, light-headedness, distended neck veins, excessive peripheral edema, and increase urination at night. Her current medications include Lotensin and Lasix for the hypertension along with Glucophage for the Type II diabetes mellitus.
The following are lab findings that are pertinent to this case:
Vitals
BP
158/98 mm Hg CBC Hematocrit
57%
Glycosylated hemoglobin (HbA1c)
7.3%
Arterial Blood Gas Assessment
PaCO2
52 mm Hg
PaOz
48 mm Hg Lipid Panel Cholesterol
242 mg/dL
HDL
32 mg/dL
LDL
173 mg/dL
Triglycerides
1000 mg/dL
1.What clinical findings correlate with M.K.’s chronic bronchitis? What type of treatment and recommendations would be appropriate for M.K.’s chronic bronchitis? 2.Which type of heart failure would you suspect with M.K.? Explain the pathogenesis of how this type of heart failure develops.
3.According to the American Heart Association 2017 new guidelines, and M.K.’s B.P. value, what stage of hypertension is she experiencing? Explain the rationale for her current medications for her hypertension. Also, discuss the impact of this disease in the U.S. population.
4.According to the lipid panel, what other condition is M.K. at risk for? According to this case study, what other medications should be given and why? What additional findings correlate for both hypertension and Type II diabetes mellitus?
5.Interpret the lab value for HbA1c and explain the rationale for this value in relation to normal/abnormal body function?

Sample Solution

Every tax should be levied in such a manner and at such a time that it gives the tax payer maximum convenience. Tax in the UK is generally collected by either taking from the tax payer before they receive the rest of the money, known as the Pay As You Earn (PAYE) system, or they pay it directly to the government (HMRC).

Economy

The cost of collecting tax should be the minimum so that a major part of collection is towards the treasury. If administration expenses consumes a large portion of tax revenue, it cannot be said it is a good tax system. Tax systems vary around the world due to historical and institutional differences, but any good system must seek the least aggregate sacrifice in its tax policies. For 2018, the UK government spent 2% of their total spending on general government where HMRC is included (Chantrill, 2019).

Extra Characteristics

Simplicity

Tax should be so simple that any tax payer can understand its computation and complications without the help of an expert. It would also reduce the chance of tax evasion as it will not bother the individual to pay tax. A simple tax system is also beneficial for the government due to spending less time and money. A tax system that treats similar economic activities in similar ways for tax purposes will tend to be simpler and avoid discrimination between people and economic activities. However it can sometimes be efficient to discriminate between different activities for tax purposes, such as UK taxes on alcohol and tobacco, and other things that harm others and the environment.

Desirability

A tax should be desirable so that the government may defend itself against public criticism, by supporting its expediency. An unjust tax will always face sharp unwillingness on the part of the tax payers to pay and they will try to evade them, every new tax must have a justification to create a feeling of acceptance. Dalton stated that “in a good tax system, there should be a double illusion that the rich should pay more than what they think they should, so the rich will be contented and the poor be

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