Which sentence structure is correct: Who did you speak to yesterday? Whom did you speak to yesterday?
The correct sentence is: Whom did you speak to yesterday? "You speak" is the subject and verb of this sentence.
A 13 year old female presents with acute onset of bilateral leg weakness. She also complains of loss of sensation in her lower extremities. Her symptoms began yesterday in her feet and have since progressed to include both legs. She denies bowel/bladder incontinence. She denies any trauma or toxin exposure. She is otherwise healthy; however, she did have a "GI bug" last week. Her physical exam is significant for bilateral leg weakness with 3/5 strength and absent patellar and ankle jerk reflexes (0/4). From what is this patient likely suffering, and what treatment is most appropriate?
The patient described is likely suffering from acute inflammatory demyelinating polyneuropathy, more commonly known as Guillain Barre Syndrome. The pathogenesis of the condition involves an inflammatory response thought to be autoimmune in nature that targets the myelin of spinal nerves. The disease progression usually begins distally and ascends. Sensory disturbances, weakness, and arreflexia are common. Classically, the condition is preceded by a bacterial gastrointestinal infection, such as c. jejenum. The greatest concern for GBS is involvement of the diaphragmatic nerves, resulting in respiratory compromise. The treatment of choice at present is IVIG. Corticosteroids have proven ineffective in the management of AIDP.
In Nathaniel Hawthorne's novel The Scarlet Letter, the author utilizes symbolism to further convey the themes of his book. Give an example of such symbolism and its significance.
Nathaniel Hawthorne's The Scarlet Letter, a novel set in Puritan Boston, explores morality and the contrast of good versus evil. Throughout the novel, the author uses symbolism to eloquently reflect upon and examine these themes. The author does so through the use of the character, Pearl, Hester Prynee's daughter, as well as his use of dark and light imagery.