Reviewing questions:

In patients with asthma, there is usually a greater than 20% drop in lung function with methacholine challenge (positive test).

Epistaxis that is prolonged and difficult to control is most likely to be a posterior bleed. Posterior bleeds are associated with the sphenopalatine artery, which arises from the maxillary artery. If medical treatment fails, an otolaryngologist may choose to ligate the maxillary artery because this procedure has a higher success rate than ligation of the external carotid artery. Anterior nose bleeds, on the other hand, nearly always arise from the Kiesselbach plexus. The Kiesselbach plexus is an anastomotic network of vessels on the anterior portion of the nasal septum.

I don't know how to use ventilators, but I got a question on it right and the references included: https://www.thoracic.org/ and https://emedicine.medscape.com/article/304068-overview.

For more information, see:

American Thoracic Society overview on mechanical ventilation. AS Fauci, E Braunwald, DL Kasper, SL Hauser, DLLongo, JL Jameson, J Loscaizo (eds), Harrison’s Principles of Internal Medicine, 16e. New York, McGraw-Hill, 2005: 1595-1599. Nye, Z. (2009). First aid for the COMLEX: An osteopathic manipulative medicine review (2nd ed.). New York: McGraw-Hill Medical. Overview of mechanical ventilation. eMedicine.

Common physical examination findings include boggy and pale nasal turbinates in addition to allergic shiners, which refers to darkening of the skin under the eyes secondary to the pooling of blood under the orbits due to swelling in the nasal cavities. First-line medical treatment of persistent seasonal allergies consists of an intranasal corticosteroid, such as budesonide, fluticasone, or mometasone, in addition to conservative measures such as allergen avoidance and patient education. Intranasal corticosteroids may provide some benefit immediately but typically take 2 weeks for peak benefit. For chronic allergies, they may be used safely on a daily basis. Seasonal allergic rhinitis is a clinical diagnosis and does not require additional imaging or laboratory workup.

S. aureus is a beta-hemolytic gram-positive cocci that grows in clusters and is coagulase positive. It is one of the leading causes of both community-acquired pneumonia and healthcare-acquired pneumonia in children. It presents with abrupt onset of fevers, chills, and lobar consolidation and commonly causes cavitation, effusions, and empyema. Risk factors for Staphylococcus aureus infection include foreign body, preceding viral infection, malignancy, diabetes, prematurity, and immunodeficiency. Children with invasive staphylococcus infection should be hospitalized and started on empiric intravenous antibiotics. A definitive antibiotic regimen is based on susceptibility (if the organism is methicillin-susceptible or resistant).

Antibiotics used to treat tularemia include streptomycin (the drug of choice), gentamicin, doxycycline, and ciprofloxacin

Tularemia

Description: When the hunters were drinking in the bar, they stayed with [him] sitting in the corner of the bar, and the fluffy and cute rabbit beside him, and the rabbit told a few dark jokes that he thought were humorous. After that, they suffered from ulcers, swollen lymph nodes, and even near-fatal pneumonia and sepsis, and were forced to give up hunting. He listened to the message contentedly, and whispered to the rabbit: [Good job]

Description (Traditional Chinese): 獵人們在酒吧酒酣耳熱之時，留到坐在酒吧一角的【他】，和他身邊蓬鬆可爱的兔子，不兔多講了幾句自認為幽默的地獄笑話。在那之後他們陸續受潰瘍，淋巴腫痛，甚至是近致乎致命的肺炎及敗血症所苦，被迫放棄打獵。 心滿意足地聽著個訊息的他，小小聲地對著兔子說：【幹得好】

Character: Tularemia

Release: September 2022

Artist: Luo Peishan (Quan Lo)

Nickname: Francis

Gender: Male

Height: 179cm

Weight: 65kg

Birth Date: 10/9 (Libra)

Personality: Claiming to be a hunter because of his interest, but the arms and equipment in his hands obviously exceed the needs of occasionally hunting wild boars. He especially loves rabbits, and his most trusted rabbit partner [Dayuan] can not only help him carry important special ammunition, but also divert the prey's attention with a cute and helpless appearance. Francis: "So what exactly is your prey?" Rabbit: "Secret ^^"

Likes: Rabbits, hunting, collecting military weapons

Dislikes: Cooking, the smell of pesticides, white eyes trespassing on the hunting ground

Links: CDC, Wikipedia

Facebook Post

going thru my first ever panic attack and it's not great gamers

do you know how free i feel rn. like ok i had to take a bit of a pay cut accepting this job but i get to work in a lab where i handle plants & chemicals, doing chemistry shit (which i focused on in my associate's), i will finally get pto, i can have a normal human schedule and not have to work graves anymore, and most importantly of all, i can stop literally handling piss shit & blood all day

أحذر حمى الأرانب | beware tularemia

Tula's heart

Touching her heart in the character art

Edit: Tularemia is a disease that can infect animals and people. Rabbits, hares, and rodents are especially susceptible and often die in large numbers during outbreaks.

Something settles heavy on your heart

Edit: Tula only lost health from using Lay on Hands to cure a disease, not every time she healed

Her magic feels wrong for the first time

There's a little too much in common

Listen to your heart / something foundational to her is a lie

not me reading the wikipedia page on stoats, getting to the "parasites and diseases" section and seeing this sentence:

tularemia is also known as "rabbit fever."

what is brennan up to. i don't trust the mind behind evan kelmp or knickolas pnackleless hob as far as i can throw him

….yeah he definitely ages backwards

shoutout to mama zigvolt (ft. sebeks older siblings) bc baby silver would’ve died from tularemia

HC that Lilia ties his long hair in a low ponytail for the first few weeks after adopting the babe idk HAHAHAH

Can you imagine attending your daughter's wedding and this thing is the groom? He approaches you all tot tot tot, extending his stinky little paw out, big beady eyes glistening with tularemia. To not upset your baby girl you shake it, spending every long second wondering if humans can contact fleas. His musty squirrel odor wafts into your nostrils assaulting your senses but you stay strong. For her... your precious angel. you resolve to be open minded. even at the cost of stuart little grandkids. So you smile and ask them how they met and she tells you he was her teacher in middle school.

Also Round 71, Round 72, Round 73, Round 74, Round 75

im soooo normal about the implications of Tula already being dead and Tula being short for tularemia. she’s being propped up by radiation. when Lila asked Tula to listen to her heart and she couldn’t because her heart isn’t beating. im going to die.

having worked in public health emergency preparedness for a couple years puts an interesting slant on my current interest spiral around chemical weapons, and now biological also. like.. one of the primary raisons d'être for the very existence of public health emergency preparedness as a field is concerns about 'bioterror.' anthrax, tularemia, plague, botulism. we would run simulation exercises and make plans about how to mass distribute doxycycline and ciprofloxacin to the local population. we would talk about what was the closest location with a cache of atropine to treat nerve gas (or just organophosphate) poisoning. still, the CBRNE plans where I worked were the absolute weakest link in our preparedness arsenal, bar none. there barely was a plan. there was a document with an outline.

and then with that background, I'll read about the history of US experiments with weaponizing anthrax, tularemia, plague, botulism, q fever, crop molds and diseases, etc. not that it comes as a surprise, but it's nonetheless remarkable how much money and effort the federal government pours into doing bioterror, and how little into managing its health effects. and it's ironic to think how much public health emergency preparedness feeds into notions of shoring up 'national security' and never imagines that the threats they would face could come from the hallowed halls of the national security state itself.

like. experimenting with diseases you can inflict on your enemies? intentionally increasing the lethality of those diseases? all blatantly appalling ethics aside, is infecting people whose governments you don't like or killing their crops or their livestock or poisoning their air or water or soil really worth introducing new threats that may very well come back to bite you? diseases spread; that's perhaps one of their hallmark qualities. I know that blowback does tend to come as a lamentable surprise, somehow, to the actors who engender it, but. jfc. it's like pouring gasoline on both your enemies and yourself while all the while designing better matches, and, I suppose, holding a small cup of water in your free hand.

Opossum facts.

about 8.3 million possums die a year.

Opossum fossils date back to the early Miocene period, with the last common ancestor fossil dating back 23 million years.

Opossums are good for our environment because they are apart of the ecosystem. However, they carry multiple diseases that could be deadly (some are leptospirosis, tuberculosis, relapsing fever, tularemia, spotted fever, and more)

Either one will still give you rabies tho

Possums actually very rarely carry rabies from what I understand!

They're body temp is too low for it to be sustainable as a rabies host :D

They can however carry leptospirosis, tuberculosis, relapsing fever, tularemia, spotted fever, toxoplasmosis, coccidiosis, and Chagas disease as well as any diseases any ticks and fleas they may have can carry :)

Once you’re down in the basement you wish your eyes would’ve betrayed you halfway through the journey there, because you can’t bear to look at the sight before you. Gerard’s bed is a mess of covers and pillows, and in the middle of the jumble lies a tiny body. You know it’s Mikey because it can’t be anyone else, but it barely looks like her. Her blonde hair is matted and wet, plastered to her forehead and red face. Her eyes are closed but her mouth is open, dry tip of her bright red tongue pressed against her crooked lower teeth, cheeks dewy and wet eyelashes resting against them. You can hear gasps in the back of her throat, like every breath she’s trying to take is a fight against her frail body, her ailing frame shivering and trembling continuously.

This is an excerpt from For Thinking I’ve Got Fuckin’ Rabies or Something (Pragmatic Beyond Any Reasoning)

For this part specifically, I wanted to write about the obvious consequences from snuggling 24/7 with a dead animal: sickness. Wednesday pointed out that tularemia is something you can get from rodents, and when I looked up the symptoms and the course of the disease, I thought it would fit very well. At this point Frank has barely come to terms with the knowledge that Mikey has been carrying around a dead squirrel, that his friend Gerard gave her that squirrel, and that apparently Frank's the only person around the siblings who sees anything wrong with that. He hasn't heard from Gerard in a while, hasn't seen either of the Ways, and he is convinced he has to go see them because something horrible could've happened. He shows up at the house and Gerard and the house itself look terrible, and he thinks it can't get any worse, until it does. Until he sees this sweet little girl in bed, sickly and looking like she could die soon. Tularemia is also called rabbit fever, and (specifically pneumonic tularemia) causes among other symptoms fever, chest pain, muscle pains, coughing to the point of expelling blood, and shortness of breath. I wanted the reader to get an image of what Mikey was suffering from without saying the words out loud. I know what bacteria has been nestling in Mikey's lungs, but you guys don't need to know that to get the picture. I want to specifically point out that a bright red tongue can be indicative of various diseases or deficiencies, and although I don't know the exact profile for tularemia, I felt the visual fit. I hope this scene conveyed what I wanted it to <3

This is my boy Skyler, who originally was made as a Rayman oc for a trashed fanfiction that was heavily inspired by the scrapped initial concept for Rayman: Raving Rabbids.

Skyler is a Toucelot (Toucan + Ocelot) with an easygoing and chummy disposition, though he can be a bit lazy and timid. It takes him a while to get used to Murfy's loudmouthed candor, with the Flying Encyclopedia not knowing what he's called (it's not in the manual) and referring to him as cat-bird, which he later accepts as a nickname.

In the story, Skyler helps Rayman and the gang escape the Rabbid arena and King Tularemia's insane army. They flee the land to Skyler's home island so they can regroup and Rayman can learn his new abilities. As it turns out, the Rabbids are causing chaos in this place too, much to the chagrin of its tiki people, and are flattening the rainforest and claiming the island as their personal resort. Skyler has been passive and timid up until this point, and with the help of his new friends, finds the courage to stand up to the Rabbids and save his tiki community and island home. Once the Rabbids are driven from the island, Skyler says he will remain there as he's ready for a vacation. Later on, the group is rejoined by him, as he doesn't want anyone else to have to lose their home to the Rabbid takeover, believing that if they together could stop them from taking over the island, they could stop them from taking over the World.