The primary seat of tubercular infection is generally in the upper part of the lung. The invading organisms settle on the surface here and cause a multiplication of the cells and an inflammatory exudate in a small area. With the continuous growth of the bacilli in the localized region, adjoining areas of the lung become affected, and there is further extension into the immediate vicinity by means of the lymphatics. Small nodules form and then coalesce to create a larger area. The body primarily defends itself with the formation of dense masses of cicatricial tissue, which function to wall off the affected area. This results in unfavorable growth conditions for the bacilli. This mode of defense, combined with the production of substances antagonistic to the toxins produced by the bacilli, is so efficacious that in the great majority of cases no further extension of the process takes place. In certain cases, however, the growth of the bacilli in the focus area is unchecked, then the surrounding tissue is killed and converted into a soft semi-fluid material; further extension then takes place. All parts of the enormous surface of the lungs are connected by a system of air tubes or bronchi, and as a result, the bacilli have favorable opportunity for distribution. This opportunity is facilitated by sudden movements of the air currents in the lung produced by coughing. The body's defense; however, can still keep pace with the attack, and even in an advanced stage, the infection can sometimes be permanently checked; in other cases, the check is temporary, the process of softening continues, and large cavities are produced by the destruction of the tissue. On the inner surface of these cavities there may be a rapid growth of bacilli. From the lungs, the bacilli are carried by the lymphatics to the lymph nodes at the root of the lungs, in which a similar process takes place; this, on the whole, is favorable, because further extension by this route is for a time blocked. The extension across surfaces continues and the abundant sputum, which is formed in the lungs and contains large numbers of bacilli, becomes the vehicle of transportation. The windpipe and larynx may become infected, as the back parts of each are more closely in contact with the sputum and are the parts most generally infected. A large part of the sputum is swallowed and infection of the intestine takes place with the lesions taking the form of large ulcers. From the intestinal ulcers there is further extension by means of the lymphatics to the large lymph nodes in the back of the abdominal cavity.

The author is considering the addition of another paragraph. Which of the following would serve as the best topic sentence of the added paragraph?

A. After leaving the abdominal cavity, the sputum makes its way to the bloodstream, where it can further infect the organism.

B. The lymphatics serve many purposes in facilitating the growth of the bacilli within the body.

C. While it may seem as if the body has given up the fight at this point, this is not the case.

D. It is within the abdominal cavity that tubercular infection finds its biggest obstacle.

For most Americans, the words "Alzheimer's disease" (AD) ?often mispronounced purposefully or accidentally as "old timers' disease" ?signify devastating memory loss and stigma. The information about AD ?often learned solely through the media ?may lead individuals to believe that AD is inevitable (it isn't), and possibly think that all AD patients receive poor care (there are many remarkably good AD units). Many individuals may envision a future burdened with more dementia patients and fewer societal resources to help support them (a real possibility). In general, pharmacists are well aware of what AD is and isn't. AD is complex and relentlessly progressive; it affects patients, loved ones, and caregivers adversely. Pharmacists can provide pertinent information about AD's myths, realities, and available symptomatic treatments. AD's harbinger is language difficulties, which include aphasia (language disturbance), apraxia (inability to carry out motor functions), and agnosia (failure to recognize or identify objects). Consequently, those with AD will often create new words for items. They may call a pencil a "list writer," or a key a "door turner." Clinicians stage AD as mild, moderate, or severe depending on the patient's cognitive and memory impairment, communication problems, personality changes, behavior, and loss of control of bodily functions. People often dismiss mild AD as normal cognitive decline or senility ?in other words, "normal" aging. For this reason, most people don't seek treatment and are diagnosed in the late-mild to early-moderate stage. In the severe stage, difficulty swallowing elevates the risk of aspiration pneumonia, which often marks the beginning of the downward spiral that ultimately ends with death; AD has no cure. A handful of pharmacologic treatments ?acetylcholinesterase inhibitors and N-methyl-D-aspartate antagonists ?alter the decline trajectory. These treatments slow disease progression, enhance cognitive function, delay cognitive decline, and decrease disruptive behaviors. Not all patients respond to these medications, but experts generally believe that those who do will show mild to moderate improvements for 6 months to a year. Although the drugs' effects are short-lived, they improve patients' quality of life and briefly enable independence. Determining when medications stop providing a therapeutic benefit and should be discontinued is challenging. Clinicians use various methods to monitor decline, including mental status tools, patient self-report, and loved ones' observations. Most clinicians continue drug treatment if the patient seems to tolerate the medication well, can afford it, and if there seems to be a benefit. With disease progression, specific behavioral symptoms including depression, agitation, hallucinations, and sleep disturbances become concerns. Antianxiety drugs, antipsychotics, and antidepressants are sometimes used to alleviate symptoms, but effective behavioral strategies are much preferred.

In paragraph 2, "harbinger" most nearly means?

A. token

B. precursor

C. messenger

D. problem

What is the value of:

i2 × i−3

A. 1

B. -i

C. 1/i

D. -1

ln e7 = 1 - x, what is x?

A. 6

B. ln 7 - e

C. -6

D. -ln e - 7

How much do you save on a purchase of $47.00 if you shop in a store on a day in which the promotion is that the store will pay the sales tax (and sales tax is 8%)?

A. $2.76

B. $0.37

C. $3.76

D. $4.76