The Tempest - Barbarism Versus Civilization Essays - Caliban

The Tempest - Barbarism versus Civilization In Shakespeare's play, The Tempest, a fundamental subject of brutality versus human advancement shows up. Shakespeare makes characters that represent images of nature or support. The imagery of the characters is gotten from their activities. These activities show Shakespeare's perspective on the boorish and the humanized, just as help the peruser build up his own assessment of each side. In this unconventional play, Prospero, the previous Duke of Milan, in the wake of being replaced of his dukedom by his sibling, shows up on an island. He liberates a soul named Ariel from a spell and thusly makes the soul his slave. He likewise oppresses a local beast named Caliban. These two slaves, Caliban and Ariel, represent the topic of nature versus support. Caliban is viewed as the portrayal of the wild; the side that is generally looked downward on. Despite the fact that from his frightful conduct, Caliban can be seen as a despicable mammoth of nature, it tends to be sensibly induced that Shakespeare's aim was to make Caliban a thoughtful character. During the primary experience, Caliban runs over brutal and indecent. While moving toward Caliban's cavern, Prospero injuriously says, ?[he] never/Yields us kind answer, which means Caliban never answers consciously. When Prospero arrives at the cavern, he calls to Caliban. Caliban suddenly reacts, There's wood enough inside. His short, smart answer and his loathsome tone, uncover the harshness he feels from having a servile existence. Caliban's discourteousness causes him to appear to be a dishonorable and abhorrent slave. Additionally, Caliban shows an outrageous displeasure toward Prospero. When Caliban is approached to approach he talks corruptly, As evil dew as e'er my mom brushed/With raven's plume from unwholesome fen/Drop on you both!?And rankle all of you o'er! Caliban's demeanor and insolence is unfitting for a worker. Be that as it may, his activities are advocated. Until Prospero showed up on the island, Caliban was his own ruler. The island was left to him by his mom, Sycorax. All things considered, Prospero assumed responsibility for the isle and in the end subjugated Caliban. ?Thou strok'st me?I cherished thee? is a piece of a statement that outlines Caliban's relationship with Prospero before he was his slave. Prospero ameliorated Caliban and gave him water and berries; he showed him how to talk, too. During this time Caliban cherished Prospero and demonstrated him the highlights of the island, The new springs, brackish water pits, desolate spot and ripe? Caliban laments helping Prospero as he says towards the finish of his discourse, Reviled be I that did as such! Caliban feels along these lines because of his detainment. Nonetheless, Caliban was subjugated on the grounds that he assaulted Prospero's little girl, Miranda. Assault requests to the peruser as a decent aim for oppression, however Shakespeare shows that Caliban merits compassio n, rather than nauseate. Caliban submitted an unlawful demonstration that merited discipline. Be that as it may, he had not been supported by society and, along these lines, didn't have the foggiest idea about any better. It is his essential nature to do as he feels. He doesn't have the foggiest idea about the distinction among good and bad. The peruser will in general feel thoughtful towards Caliban in light of the fact that he is rebuffed and mistreated for lead he was unable to control. Prospero says, A demon, a conceived fallen angel, on whose nature/Nurture can never stick? which clarifies why despite the fact that Prospero instructed Caliban the methods of acculturated life, he despite everything followed up on his normal impulses. Caliban still shows his common conduct by being gruff thus called vile as a slave. However, when the peruser comprehends Shakespeare's expectation, it very well may be surmised that Caliban is only a thoughtful character who has lost his spirit. He is vulnerable among the li ves of the enlightened, in light of the fact that edified life is one he will never embrace. Caliban is a man of nature, however he ought not be viewed as less noteworthy than somebody from development. Shakespeare depicts Caliban as an appalling and rough looking brute, which is the way individuals of nature are envisioned by residents of society. Caliban's appearance epitomizes the savage creature nature inside him. Be that as it may, Caliban has, what no man of society has, immaculateness and honesty. Caliban acts not to satisfy others however to fulfill himself. He has an instinctive comprehension of the common world that draws out an affectability higher than that of the humanized. Shakespeare gives Caliban probably the best verse in the play,

Planning And Policies In The Tourism Industry

Arranging And Policies In The Tourism Industry In todays quickly changing business situations it is a basic action for each goal, to forestall aggravation in the travel industry. Factory and Morrison, (1998). The creator, state that a goal is profoundly affected by the wide-run impacts of the travel industry, it is in this manner crucial to get ready for any turn of events. As indicated by J. C. Henderson, (2005), numerous specialists have moved toward the issue on the travel industry arranging and arrangements through alternate points of view; the fleeting and spatial advancement of goals the effects of improvement, government development approaches, arranging objectives, advertising issues and themes examined. In addition, a similar creator makes reference to the different assessments of various creators who make referenced about the fundamental factors that would energize the travel industry improvement at a specific goal Critical impacts identify with openness (Prideaux, 2000), fascination and comfort guidelines (Gunn, 2004), mindfulness and positive pictures (Johns and Mattson, 2005) related with advancement and promoting (Buhalis, 2000), a steady government (Weaver and Lawton, 2002) and a quiet and stable condition (Poirier, 1997). Arranging approach the travel industry arranging is characterized as a complete, composed and proceeding processthat advance the benefit of all of society According to (Stifel, 1990), society advantages and government assistance ought to be the principle focal point of all partners engaged with choices making relating to any travel industry improvement. Also, the travel industry arranging has been characterized as a procedure dependent on research and assessment, which tries to enhance the potential commitment of the human government assistance and natural quality, (Tosun and Jenkins, 1998). In the above proclamation, Tosun and Jenkins, concur with Stifle expressing that human government assistance is in reality to be thought of while getting ready for the travel industry improvement and on it contended that travel industry ought not just investigate sightseers numbers and financial addition, yet such advancement ought to be earth sound. Significance of Tourism linkage Be that as it may, arranging requires the incorporation of the travel industry into other sectors㠢â‚ ¬Ã¢ ¦ Timothy, (1999). Timothy contends that travel industry can't work all alone, (as it is naturally dependant) and depend on different divisions of the economy, for example, farming, industry and transportation, to exist. There is the need to make linkage. As indicated by Nikolaos Karangiannis 2003, absence of a general coordinated approach has restricted the commitment of the travel industry development to the countrys financial development.[15] Therefore the creator makes reference to that the need to formulae strategies for monetary rebuilding and enhancement was prominent. The legislature in Jamaica chooses in this way, to make linkage between the travel industry, ware creation areas, and reciprocal and related administrations so as to revive the business, increment financial increase and seriousness. The travel industry Planning and strategies Specialists have an imperative job and open venture and usage of star the travel industry strategies can help in guaranteeing that such conditions do win. (Joan C. Henderson, 2006) Government approach is tied in with affecting the manner in which individuals use their assets and the manner in which they identify with one another (inside and across state and national limits) and their condition. (Clare A.Gunn and Turgut Var, 2002) express that extraordinary abilities are required to comprehend the working of the travel industry and to figure approaches. They included strategies, arranging and improvement is at any scale, from national to nearby and their motivation and reasons varies starting with one goal then onto the next. (Taylor 1994), government holds the obligation regarding examination and rule advancement, particularly in three zones: travel markets, existing and potential; the travel industry physical plant; linkages between showcase needs and physical and physical plant improvement. Further contentions, by Clare (A.Gunn and Turgut Var, 2002), expressed that despite the fact that administration intercession is essential to control effect of divided improvement on the earth and society, it has additionally been seen that free enterprise nations which receive a free enterprise the travel industry arrangement by private division, has next to no administration mediation. The conviction that political quietness, not picturesque or social attractions, comprises the first and focal prerequisite of the travel industry (Richter and Waugh, 1986, p. 320) (Ritcher 1994), concurs with Clare A.Gunn and Turgut Var, expressing that the reason for the travel industry strategies contrasts from one goal to the next as, in certain nations the travel industry has intentionally been coordinated toward expanded migration with the expectation that guests will become residents㠢â‚ ¬Ã¢ ¦stimulating of venture to build national riches as indicated by similar creators it is concurred that unnecessary the travel industry development may request modification of approaches; preservation arrangements relating to condition, strategies for land use are a few models maintainable arrangements. Legislatures of countries, areas, states and networks have the decision of sitting idle or accomplishing something helpful about open the travel industry strategies. (Sheep and Davison 1996) Besides, creating nations are regularly restless to design yet unfit to govern㠢â‚ ¬Ã¢ ¦this is impossible by a full scale or national-level approach(Cevat Tosun, Dallen J. Timothy 2001).With reference to Turkey, as traveler goal, Cevat Tosun, Dallen J. Timothy, affirm Stifels meaning of arranging, expressing that an over-centralization of the travel industry arranging and poor managerial practices and strategies definition have neglected to advance basic great of the general public, since government hesitance and carelessness to thinking about local and neighborhood conditions. At long last as per Clare A. Gunn, Turgut Var, 2002, governments have the limit as well as the obligation of making, actualizing and auditing arrangements that arrangement the travel industry. [6] According to similar creators, the travel industry organizers need to investigate three principle angles, to be specific, monetary, socio-social and ecological, when anticipating the travel industry ventures for specific goals. Exhaustive arranging process and wise detailing of arrangements will overcome hindrances to the travel industry arranging in every visitor goal territory and lead to feasible turn of events. End, exact proof through the world plainly shows that the model goals for effective the travel industry are those that have grasped the travel industry arranging idea (Mill and Morisson 1997). Obstructions to the travel industry advancement Economical Tourism in the event that travel industry is to be genuinely advantageous to all concerned㠢â‚ ¬Ã¢ ¦ and practical in the long haul, it must be guaranteed that assets are not over-expended, that normal and human situations are secured, that travel industry is coordinated with different exercises, that it gives genuine advantages to the neighborhood communities㠢â‚ ¬Ã¢ ¦that nearby individuals are included and remembered for the travel industry arranging and usage, and that societies and individuals are regarded. (Eber, 1992). The World Tourism Organization characterizes practical the travel industry as the travel industry which prompts the board of all assets so that monetary, social and tasteful needs can be filled while keeping up social trustworthiness, basics environmental procedures, natural decent variety and life emotionally supportive networks. Creating markers for maintainable the travel industry The most huge endeavor so far to create markers of economical the travel industry has been embraced by the World Tourism Organization (WTO) through its Environment Task Force (Dymond, 1997; Manning Dougherty, 1995; Manning et al., 1996). [9] Manning et al. consider that the fundamental motivation behind the WTO, in recognizing eleven worldwide satisfactory practical the travel industry center markers is to help organizers and chiefs in their assignments. Figure 1 presents center markers of economical the travel industry (WTO) Notwithstanding, L.Twining-Ward R. Head servant, 2002, challenged that the above structure has its constraints. It is seen that however, the above markers speak to an insightful endeavor towards maintainable the travel industry advancement, no arrangement has been made for directing partners in the usage of same; that is, changing over pointer results into the board activity. Besides Laws et al., express that every goal is novel and in this way needs to think about the goal neighborhood qualities and its own elements that may impact economical the travel industry markers. Arrangement producers ought to comprehend that there is no conventional model for a few goals, yet undoubtedly strategies must be customized by goal points of interest. In addition, it is of fundamental significance to audit approach and methodology as a goal develop with time; current arrangement may not be satisfactory for managing future issues in a similar goal. (Laws et al., 1998:9) [10] Concurring L.Twining-Ward R. Steward, 2002, Samoas Sustainable Tourism Status Report 2000, is a genuine model a powerful arranging apparatus which helped Saoma Visitors Bureau in creating proper activity plans and the travel industry mindfulness programs therefore. Figure 2, is an adjusted model of Saomas successful arranging and observing framework for reasonable the travel industry improvement, which will be accustomed to evaluating arranging process in Grand Baie. Hypothetical system for reasonable arranging Figure 2 arranging process, Source: adjusted from L.Twining-Ward R. Head servant, 2002 Stage 1. Venture Design/Study readiness Stage 7.Review and improve observing framework Stage 6. Execute activity design and impart results to Stakeholders Stage 2. Degree issues plan Goals destinations Stage 5 arrangement Action plan Stage 3. Review/Develop and screen markers Stage 4. . Investigation and Synthesis Applying L.Twining-Ward R. Head servant, 2002, model on investigate arranging in Grand Baie: Stage 1: Design and study arrangement; at this phase there is the need to take choices for arranging, that will be engaged with arranging process, (resi

History, Culture and Self Discovery in Amy Tan’s Joy Luck Club Essay

History, Culture and Self Discovery in Amy Tan’s Joy Luck Club  â â â In the novel The Joy Luck Club, by Amy Tan, the connection between history, culture and character is delineated through the portrayals of seven ladies. In these accounts the ladies talk about occasions of their past and the peruser can perceive how it influences them sometime down the road. What's more, they likewise examine how they have been formed by social desires. These two things influence both the moms and girls in the novel.  â â â The best case of how close to home history influences the turn of events or loss of a personality is through the tales of Ying-Ying St. Clair. The occasions in Ying-Ying’s early life anticipate ones that happen later in her life. For instance, when Ying-Ying was a little youngster she fell over the edge a vessel and was lost in the water. Indeed, even her name signifies clear reflection which anticipates her future loss of personality (Tan). Afterward, she moved to the United States and wound up being stuck on Angel Island Immigration Station for three weeks, lost in an ocean of migration categories(Tan 107). For an incredible duration she had the option to see things before they occurred, however this didn't permit her to forestall the loss of her feeling of self.  â â â During Ying-Ying’s first marriage she assumes the job of a faithful spouse so well that she gets one and places it above everything else. Later in the book when she thinks back on it she states, I turned into an alien to myself(Tan 280). After this the man is unfaithful to her and leaves her for a show vocalist. It is to this occasion she properties the loss of the brilliant side of her tiger sprit. Long after this, when St. Clair started pursuing her, she considered this to be an indication that she would likewise lose the other portion of h... ...es she needs to keep the house and is in charge of her life once more.  â â â Many of the characters in the novel are battling to get themselves. Individual history is a conspicuous supporter of the advancement of the characters' faculties of self. The occasions that happen in a character’s past impact their mentalities toward themselves and the manner in which they treat their girls. The two societies that meet in the families depicted additionally impact these mentalities. It is just when the characters consider both these elements would they be able to start to find their actual selves. Work Cited Tan, Amy. The Joy Luck Club. New York: Random House, 1989. Sources Consulted Do, Thuan Thi. Chinese-American Women in American Culture. 1992 http://www.ics.uci.edu/~tdo/ea/chinese.html Jokinen, Anniina. Anniina's Amy Tan Page. 1996 http://www.luminarium.org/contemporary/amytan/

David Berry A Fearless Innovator with a Passion for MIT

David Berry A Fearless Innovator with a Passion for MIT As Technology Reviews 2007 Top Young Innovator of the Year, MIT grad Dr. David Berry knows a thing or two about success. Though he is only 29 years old, he has 24 patents-pending and has been touted as a fearless innovator with new and insightful ways to tackle problems. While he admits that he wouldnt jump out of a plane, his mantra that big ideas require big risks is evidenced by his various research endeavors. As an MIT undergrad, he worked for two and half years Ram Sasisekharan, a professor of Biological Engineering, and did his senior thesis project on visual image processing in the Schiller Lab. More recently, he has tinkered with bacteria to make them produce a petroleum-like fuel, engineered a protein that shows promise as a stroke treatment, and developed polymers that can kill cancer cells. Berry may not know the exact ingredients in the special sauce that makes MIT such a mecca of talent, but its clear that he cant get enough of its taste. He arrived at MITs campus in 1996 as an undergrad and has not ventured far from the Institute ever since. And why should he? After graduating in 2000 with a degree in Brain and Cognitive Science, he entered the Harvard-MIT Health Sciences and Technology program and completed his PhD in Bioengineering in the famed Langer Lab and his medical degree from Harvard Medical School. Now a Principal at Flagship Ventures, a leading venture capitalist firm located down the street from MIT, David plays an active role in developing biotech companies. From the vantage point of his office overlooking the Boston skyline, it seems that life is good for Berry and he admits that hes having a blast. I asked him if he always knew what he wanted to do with his life, and he admitted that he always had a plan but never followed it. While his interests included business and management, David originally wanted to become a neuro or orthopedic surgeon. In his senior year of college, he decided to take the MD-PhD route and make research a priority. He was able to finish his Ph.D relatively quickly, partially due to his ability to pipette with both hands simultaneously (!) Armed with the skill of ambidexterity, he was well on his way to becoming a professor when he received a call from Flagship Ventures and decided to focus his career on finance and technology-based entrepreneurship. He is currently focusing on two companies: LS9, the renewable petroleum company whose technology he helped develop, and T2 Biosystems, a diagnostic company that will improve medical decision-making and treatment. As a bona fide graduate, Berry remains active in the MIT community. He is on MITs board of trustees, called the Corporation, which ensures that the Institute adheres to the purposes for which it was chartered and that its integrity and financial resources are preserved for future generations as well as for current purposes. Only one person is chosen from 160 MIT alums nominees, so to the 5-year term position is clearly an honor and a privilege. Serving on the Corporation allows Berry to contribute to the evolution of MIT. He thinks that MIT is true to itself as a school and provides its students with the best skills sets, experiences, and background in science and engineering; graduates have innumerable opportunities since everyone knows that you have earned your Brass Rat. In addition to pushing its students to, he notes that MIT constantly pushes itself to improve- as evidenced by the rising success of the Sloan Business School. In spite of all his success, Berry remains humble- he doesnt think that he could have gotten into MIT now, given his less-than-perfect SAT scores (I respectfully disagree!). His advice to current high school students is to Go to MIT! Well, he also thinks that there are many rumors and stereotypes in the college application process and student should do their own research by talking to people who attend the schools on their wish list. Though these people may be quick to complain, he suggests paying more attention to what they say they enjoy. He also emphasizes that classes arent everything. His high school extracurricular activities included music (he played the piano and saxophone, and was a member of a Ska band) and sports (competitive tennis and soccer) in addition to the classic science and math clubs. His athleticism continued at MIT, where he was on the ski team, rowed crew, and participated in intramural sports. His final word of advice is that school is a great place to be, so take the time to mentally explore and learn a lot about yourself. (The photo is from the MIT Corporations website: http://web.mit.edu/corporation/members/Berry-D.html)

The Daily PANCE and PANRE Midterm Exam

Questions 1-30 Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again Start Congratulations - you have completed Questions 1-30. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%% %%FORM%% Have Your Exam Results Emailed to You Enter your name and email address below to have your results as well as the test questions, your answers and the correct answers delivered to your inbox. Name First Last Email mTouch Quiz Populated FieldsmTouch Quiz will automatically populate the fields below. Feel Free to add additional fields for the Quiz Taker to complete using the "Add Fields" options to the right.Quiz NameThe name of the quizResults SummaryScoreThe number of correct answers. 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This iframe contains the logic required to handle Ajax powered Gravity Forms. jQuery(document).ready(function($){gformInitSpinner( 7, 'https://www.thepalife.com/wp-content/plugins/gravityforms/images/spinner.gif' );jQuery('#gform_ajax_frame_7').on('load',function(){var contents = jQuery(this).contents().find('*').html();var is_postback = contents.indexOf('GF_AJAX_POSTBACK') >= 0;if(!is_postback){return;}var form_content = jQuery(this).contents().find('#gform_wrapper_7');var is_confirmation = jQuery(this).contents().find('#gform_confirmation_wrapper_7').length > 0;var is_redirect = contents.indexOf('gformRedirect(){') >= 0;var is_form = form_content.length > 0 var mt = parseInt(jQuery('html').css('margin-top'), 10) + parseInt(jQuery('body').css('margin-top'), 10) + 100;if(is_form){jQuery('#gform_wrapper_7').html(form_content.html());if(form_content.hasClass('gform_validation_error')){jQuery('#gform_wrapper_7').addClass('gform_validation_error');} else {jQuery('#gform_wrapper_7').removeClass('gform_validation_error');}setTimeout( function() { /* delay the scroll by 50 milliseconds to fix a bug in chrome */ jQuery(document).scrollTop(jQuery('#gform_wrapper_7').offset().top - mt); }, 50 );if(window['gformInitDatepicker']) {gformInitDatepicker();}if(window['gformInitPriceFields']) {gformInitPriceFields();}var current_page = jQuery('#gform_source_page_number_7').val();gformInitSpinner( 7, 'https://www.thepalife.com/wp-content/plugins/gravityforms/images/spinner.gif' );jQuery(document).trigger('gform_page_loaded', [7, current_page]);window['gf_submitting_7'] = false;}else if(!is_redirect){var confirmation_content = jQuery(this).contents().find('.GF_AJAX_POSTBACK').html();if(!confirmation_content){confirmation_content = contents;}setTimeout(function(){jQuery('#gform_wrapper_7').replaceWith(confirmation_content);jQuery(document).scrollTop(jQuery('#gf_7').offset().top - mt);jQuery(document).trigger('gform_confirmation_loaded', [7]);window['gf_submitting_7'] = false;}, 50);}else{jQuery('#gform_7').append(contents);if(window['gformRedirect']) {gform Redirect();}}jQuery(document).trigger('gform_post_render', [7, current_page]);} );} ); jQuery(document).bind('gform_post_render', function(event, formId, currentPage){if(formId == 7) {} } );jQuery(document).bind('gform_post_conditional_logic', function(event, formId, fields, isInit){} ); jQuery(document).ready(function(){jQuery(document).trigger('gform_post_render', [7, 1]) } ); Your answers are highlighted below. Question 1A 52 year-old male presents complaining of urinary frequency, with hesitancy, and nocturia for the past few months. During his physical examination, you note a nontender, non-enlarged prostate with an isolated right posterior lobe nodule. Which of the following options is most appropriate?Aorder a serum acid phosphatase levelBinitiate prazosin and schedule a follow-up appointment in 6 weeks Crefer the patient for an ultrasound of the prostate and order a PSA levelDreassure the patient and schedule a follow-up appointment in six monthsEinitiate norfloxacin therapy for 7 days and schedule follow-up in two weeksQuestion 1 Explanation: This patient has an isolated nodule of the prostate gland — cancer until proven otherwise. You should order an ultrasound and a PSA. BPH will present as diffuse enlargement, and not a discrete nodule.Question 2Which term is used to describe the characteristic concave or "spoon-shaped" nails of iron deficiency anemia?AleukonychiaHint: Leuko nychia is often associated with hypoalbuminaemia that causes partial or complete white discoloration of the nails. Leukonychia may also appear as a rare side effect of systemic chemotherapy in some oncological patients but may also be present with arsenic poisoning, renal failure pneumonia, or heart disease. BkoilonychiaCclubbingHint: Clubbing of the nails is an actual thickening or elevation of the nail bed - it is a sign of release of TNF associated with pulmonary disorders (tissue necrosis factor) typically found in bronchiectasis, lung cancers and cystic fibrosis (the nails are NOT necessarily cyanotic.) DonycholysisHint: Onycholysis is a painless separation of the nail from the nail bed. Several or all nails are usually affected - there are many causes. EOnycholysis is a painless separation of the nail from the nail bed. Several or all nails are usually affected - there are many causes. Hint: Paronychia is an infection of the nail bed and nail margin, usually from trauma or more commonly, nail-biting.Question 2 Explanation: Koilonychia is a spoon-shaping of the nail itself. It is usually a result of iron deficiency anemia. Leukonychia is often associated with hypoalbuminaemia that causes partial or complete white discoloration of the nails. Leukonychia may also appear as a rare side effect of systemic chemotherapy in some oncological patients but may also be present with arsenic poisoning, renal failure pneumonia, or heart disease. Clubbing of the nails is an actual thickening or elevation of the nail bed - it is a sign of release of TNF associated with pulmonary disorders (tissue necrosis factor) typically found in bronchiectasis, lung cancers and cystic fibrosis (the nails are NOT necessarily cyanotic.) Onycholysis is a painless separation of the nail from the nail bed. Several or all nails are usually affected - there are many causes. Paronychia is an infection of the nail bed and nail margin, usually from trauma or more commonly, nail-biting.Question 3Which of the following is NOT a characteristic feature of the nephrotic syndrome?AproteinuriaBhematuriaChypoalbuminemiaDhyperlipidemiaEgeneralized edemaQuestion 3 Explanation: Hematuria is present in NEPHRITIC syndrome. Nephrotic syndrome characteristically includes proteinuria (>3.5 gm/day), with resulting low serum albumin, hyperlipidemia, hypertension, hypercoagulability, and generalized edema (from oncotic third-spacing)Question 4A patient describes a history of recurrent bouts of uveitis. Her chemistry panel reveals elevated serum calcium and uric acid levels. Her anergy screen is negative. Her chest x-ray demonstrates bilateral hilar adenopathy. Which diagnosis is most likely?ASilicosisBSarcoidosisCAlpha-1 antitrypsin deficiencyDHistoplasmosisETuberculosisQuestion 4 Explanation: Sarcoid typically presents with hilar lvmphadenopathy and noncaseating granulomas of the lungs (and other organs). In addition, patients may get eye involvement (uveitis). Elevations of ACE, Calcium and uric acid are frequently seen.Question 5A 34-old female presents complaining of symmetrical redness and swelling of the small joints of her hands (PIPs and MCPs). She has noted that the symptoms are worst in the morning . Her erythrocyte sedimentation rate is elevated and her rheumatoid factor is negative. Which of the following diagnosis is most likely?Aprogressive systemic sclerosisHint: PSS involves squamous cell thickening and sclerosis causing taut skin of the face and hands and difficulty with esophageal motility. BCREST syndromeHint: CREST syndrome is a subset of PSS; CosteoarthritisDrheumatoid arthritisEankylosing spondylitis Hint: Ankylosing spondylitis would have an elevated ESR and negative RF, but mainly involves the SI joint and lumbar/thoracic spine fusion (bamboo spine)Question 5 Explanation: In spite of the negative RF, Rheumatoid arthritis is the most likely diagnosis. RA characteristically includes small joint symmetrical arthritis, with an elevated ESR (therefore inflammatory, and not OA). 80% of patients with RA will have a positive RF, but 20% will be negative. PSS involves squamous cell thickening and sclerosis causing taut skin of the face and hands and difficulty with esophageal motility. CREST syndrome is a subset of PSS; Ankylosing spondylitis would have an elevated ESR and negative RF, but mainly involves the SI joint and lumbar/thoracic spine fusion (bamboo spine)Question 6A 27 year-old nulliparous female presents because she's been trying to get  pregnant for two years, but has failed. She relates a history of a misdiagnosis of appendicitis that lead to abscess formation when she was 14 years old. Which of the following diagnostic studies would be most helpful at this point in her evaluation?ATSH levelHint: The TSH level would not be indicated (she has not had a pg loss)BhysterosalpingogramClaparoscopyHint: lap could diagnose the tubal scarring but would be done after an abnormal HSGDPAP smearHint: Pap smear is screening for cervical cancer and not indicated in this case of infertility;Epelvic ultrasoundHint: pelvic US would yield nothing diagnostically about the tubes.Question 6 Explanation: While I would disagree that an invasive procedures like HSG should be done first-line, the thing to reme mber in this question is that the patient has reason to have tubal scarring from adhesions (and there is no better answer listed to choose), so, for a board exam I would choose this answer. The TSH level would not be indicated (she has not had a pg loss), lap could diagnose the tubal scarring but would be done after an abnormal HSG. Pap smear is screening for cervical cancer and not indicated in this case of infertility; and pelvic US would yield nothing diagnostically about the tubes.Question 7A 14 year-old is experiencing a severe asthma attack. Although he is using accessory muscles to breath, auscultation of his chest reveals no audible wheezing. His heart rate is 160 and his respiratory rate is 52. Which of the following arterial blood gases represents the worst prognosis?ApH = 7.52; pC02 = 28; p02 = 80BpH = 7.44; pC02 = 38; p02 = 70CpH = 7.60; pC02 = 18; p02 = 60DpH= 7.40; pC02 = 40; p02 = 60E pH = 7.27; pC02 - 62; p02 = 64Question 7 Explanation: This patient has a RR of 52. I f she is ventilating, she is blowing of C02 (an acid) and would be alkalotic and should have a low C02. A pH which is acidic with a pC02 which is elevated means that she is no longer ventilating at all (she needs mechanical ventilation or she will die).Question 848 year-old nurse, with a body mass index of 31, presents for an evaluation for back pain. She relates that historically, she had a positive PPD test a year ago and did not follow-up as directed. She has recently been experiencing night sweats and coughing. An x-ray of her lumbar spine reveals osteopenia and cortical breakdown of vertebral bodies L4 and L5. Which of the following diagnosis is most suspect?Acompression fractures secondary to obesityBdegenerative joint diseaseCPotts diseaseDcompression fractures secondary to osteoporosisEspondylolisthesisQuestion 8 Explanation: Pott's disease is TB of the spine. She could have any of the other diseases; but the question states that she had a positive PPD and did not take meds. ..that is the clue that she has active TB in the spine.Question 9While suturing a wound, you opt to use lidocaine with epinephrine. The rationale for your choice is:Aan increase in the absorption of the lidocaine.Ban increase in the diffusion of the lidocaine into the nerve's myelin sheath.Can increase in the blood flow to the area of injection.Dan increase in the duration of anesthesia.Ea decrease in the risk of infection at the site of injection.Question 9 Explanation: Lidocaine with epinephrine both increases duration of anesthesia and decreases blood flow to the area of injection-i.e. penis, nose, fingers, toesQuestion 10An EKG demonstrates a PR interval of 0.16 seconds, a P to QRS relationship of 1:1, a variable heart rate and an R to R interval that is noted to accelerate ad decelerate during the respiratory cycle. What is the diagnosis?AWenckebachHint: Wenckebach AVB would have a non-conducted P wave. Bthird degree heart blockHint: Third degree AVB would have a non-conducted P wave. Catrial fibrillationHint: A fib would have no P waves and an irregularly irregular rhythmDsinus arrhythmiaEatrial flutterHint: A flutter would have "flutter waves" or a regular rhythm of 150.Question 10 Explanation: This is sinus arrhythmia. Wenckebach & third degree AVB would have a non-conducted P wave. A fib would have no P waves and an irregularly irregular rhythm. A flutter would have "flutter waves" or a regular rhythm of 150.Question 11A 42 year-old female presents after finding a firm, painless bump in her right eyelid. On examination, you note a 6 mm mass within the tarsus of the right eye. The skin is freely movable over the mass. The remainder of the ophthalmoscopic examination is unremarkable. Which of the following is the most likely diagnosis?ApterygiumHint: Pterygium involves the sclera. BchalazionCectropionHint: Ectropion is when the eyelid sags outwardly and the lid doesn't close well.Dexternal hordeolumHint: Hordeolum are acute and red and painful.Einternal hordeolum Hint: Hordeolum are acute and red and painful. Question 11 Explanation: A chalazion is a painless chronic mass in the eyelid. Hordeolum are acute and red and painful. Pterygium involves the sclera. Ectropion is when the eyelid sags outwardly and the lid doesn't close well.Question 12A 22 year-old patient was involved in an automobile accident and is comatose. Which of the following diagnostic modalities would be least useful in this patient's evaluation?ACT scanHint: CT would be the imaging test of choice. Bskull radiographsCMRI scanHint: MRI should be done for a more chronic bleed.DEEGHint: EEG would help to establish brain activity. EPET scanHint: PET scan (while not done often) would establish physiologic function (uptake of glucose). Question 12 Explanation: Of these choices, the skull film is LEAST useful. Whether or not the skull is fractured, any LOC in a head trauma requires imaging for bleeding. CT would be the imaging test of choice. MRI should be done for a more chronic bleed. EEG would help to establish brain activity. PET scan (while not done often) would establish physiologic function (uptake of glucose). A positive or negative plain film of the skull would supply NO FURTHER INFORMATION.Question 13Which white blood cell disorder is characterized by the presence of the Philadelphia chromosome in 90% of cases?Achronic lymphocytic leukemia (CLL)Hint: CLL has no clear distinguishing feature except increased lymphocytes.B acute lymphocytic leukemia (ALL)Hint: ALL occurs in children. Cchronic myelogenous leukemia (CML)Dacute myelogenous leukemia (AML)Hint: AML is associated with Auer rodsEmultiple myelomaHint: Multiple myeloma has Bence-Jones protein. Question 13 Explanation: Philadelphia Chromosome occurs in CML. ALL occurs in children. AML is associated with Auer rods. Multiple myeloma has Bence-Jones protein. CLL has no clear distinguishing feature except increased lymphocytes.Question 14Which of the following thyroid profiles is most compatible with a diagnosis of primary hypothyroidism?Aa low TSH (thyroid stimulating hormone) level and a high T4Ba low TSH level and a normal T4Ca low TSH level and a low T4D a high TSH level and a low T4Ea high TSH and a high T4Question 14 Explanation: Low T4 is diagnostic for low thyroid function. If the pituitary is normal (as in primary thyroid disease) the TSH should be high as the pituitary tries to stimulate the failing thyroid gland.Question 15All of the following are factors that predispose a patient to the development of  gastroesophageal reflux EXCEPT:Ahiatal hernia.BpregnancyCscleroderma.Dan incompetent esophageal sphincter Epernicious anemia.Question 15 Explanation: Pernicious anemia has no correlation with GERD. It is an autoimmune destruction of the gastric parietal cells that make intrinsic factor. Signs Methyl Dopa (Aldomet) is indicate d in pg. ACEI's (captopril) are contraindicated in pg. B-Blockers can be used but may cause growth restriction. Diuretics are not used in pg. CCB's and centrally acting agents (while not contraindicated) should be avoided.Question 176 year-old child falls onto his right arm. An x-ray demonstrates a buckle in the cortices of the distal radius, proximal to the growth plate, without angulation. What is the term used to describe this fracture?ASalter-Harris Type IIIBSalter Harris Type IVCSalter Harris Type VDtorusEgreenstickHint: Greenstick fracture is also common in children in long bones and is a fracture which "bends" the bone without fracturing it.Question 17 Explanation: Torus or buckle fracture is most common in a child. This is proximal to the epiphyseal plate and so is not a Salter-Harris issue. Greenstick fracture is also common in children in long bones and is a fracture which "bends" the bone without fracturing it.Question 1855 year-old male presents complaining of "difficulty wrtiing" using his dominant hand and some "slurred" speech. He has a h/o hypertension, DM type II, and hypertriglyceridemia. Which of the following would you anticipate to find on a CT scan of his head, as the explanation for his chief complaint?Ahemorrhage in the distribution of his posterior cerebral arteryBhemorrhage in the distribution of the middle cerebral arteryChypodensity measuring 12 mm by 21 mm in the distribution of the posterior cerebral arteryDhypodensity measuring 4 mm by 4 mm in the internal capsuleE calcifications bilaterally, in the third ventriclesHint: Calcifications are not indicative of stroke at allQuestion 18 Explanation: The main clue in this question is that most strokes are ischemic - especially with THIS patient's history (ruling out hemorrhagic infarct - A & B). Calcifications (E) are not indicative of stroke at all. When trying to decide between C & D - the size of the area needs to correlate with the patient's sxs. If the patient had a HUGE infarct (12 x 21) he would have significantly more sxs than just some slurred speech and difficulty writing. (In addition, as it turns out, the internal capsule is supplied by the MCA - which is the most common vessel involved in an ischemic stroke)Question 19A female in her third trimester of pregnancy developed hypertension, diffuse edema, proteinuria and hyperreflexia. She was treated with intravenous magnesium sulfate and is now hyporeflexic and drowsy. What do you prescribe now?Acalcium BdiazepamCan amphetamineDadditional magnesiumEoxygenQuestion 19 Explanation: Pre-eclampsia causes hyper-reflexia. Magnesium is the treatment. The sign of Mg toxicity is loss of reflexes...this is treated with Calcium.Question 20This papulosquamous eruption is most common in young adults. A single oval patch is generally noted several days before a more generalized, fawn-colored rash erupts. This rash is most prevalent on the trunk, and the proximal upper and lower extremities. The rash spontaneously disappears over 5 to 6 weeks. The diagnosis is:Apityriasis rosea.Btinea corporisCpsoriasis.Datopic dermat itis.EsporotrichosisQuestion 20 Explanation: This is the classic presentation of pityriasis rosea. Remember that the differential diagnosis includes secondary syphilis, so if a positive sexual history - consider ordering a VDRL/RPR. The "herald" patch which is described is pathognomonic for pityriasis.Question 21A patient presents complaining of generalized swelling. Her urine is positive for protein. Her serum testing reveals hyperlipidemia and hypoalbuminemia. Which of the following is the most likely diagnosis?AcirrhosisBnephrotic syndromeCnephritic syndromeDcystititsEpyelonephritis Question 21 Explanation: This is a classic presentation of nephrotic syndrome.Question 22A patient is experiencing an acute exacerbation of asthma. Which of the following drugs would be the least useful in the management of this asthma attack?AalbuterolBcromolyn sodiumCprednisoneDtheophylineEepinephrineQuestion 22 Explanation: Cromolyn is a mast cell stabilizer and must be present in the system PRIOR to the symptoms. It would be useless in a patient already having symptoms.Question 23A 34 year-old female patient presents to the ER with sharp pleuritic-type chest pain. An x-ray reveals pericarditis. On more careful questioning, the patient admits to a polyarticular arthritis involving the small joints of her hands. Her obstetrical history is positive for two third trimester spontaneous abortions. At this point, you would suspect which autoimmune process as the cause of her symptoms:ARheumatoid arthritisBSystemic Lupus ErythematosisCWegener's granulomatosis DSjogren's SyndromeESclerodermaQuestion 23 Explanation: 40-60% of patients with SLE have serositis (pleuritis and pericarditis). That, combined with joint pains, habitual AB - should cause you to order an ANA.Question 24A patient with AIDS develops severe headaches. A CT scan demonstrates multiple ring-enhancing lesions of the brain. What diagnosis is most likely?AToxoplasmosisBHistoplasmosisClymphomaDCytomegalovirusHint: CMV i s common as well and typically causes retinitis. EHerpes encephalitis Hint: Herpes encephalitis can happen frequently too, but causes a diffuse encephalitis.Question 24 Explanation: Toxo occurs commonly in HTV, and is a parasitic infection causing ring-enhancing lesions (but lots of things can cause ring-enhancing lesions). CMV is common as well and typically causes retinitis. Herpes encephalitis can happen frequently too, but causes a diffuse encephalitis.Question 25A Caucasian male has a history of a meconium ileus as a newborn, steatorrhea and a positive sweat test. What is the most likely diagnosis?Avon Gierke's diseaseHint: Von Gierke disease is a condition in which the body cannot break down glycogen for energy. Gycogen is stored in the liver and muscles and is normally broken down into glucose when you do not eat. Von Gierke disease is also called Type I glycogen storage disease (GSD I).BHurler's syndromeCcystic fibrosisDHunter's syndromeECri du chat syndromeQuestion 25 Explanation: This is the classic presentation of CF.Question 26A 32 year-old male presents with dyspnea and a nonproductive cough. His is tachycardic, tachypneic and febrile. Auscultation of his chest reveals scattered rhonchi. His chest x-ray demonstrates a diffuse interstitial infiltrate. His ABG demonstrates moderate hypoxemia and his LDH is elevated. What is the most likely diagnosis?AStreptococcal pneumoniae pneumoniaHint: S. pneumo is the most common CAP, but would present with a focal/lobar consolidationBMycoplasma pneumoniae pneumonia Hint: While mycoplasma patients can be acutely ill, they are more likely (especially on the Boards) to present as mildly ill with normal PE and no hypoxia. CPneumocystis carinii pneumoniaDBowen's diseaseESteven-Johnson syndromeQuestion 26 Explanation: Many AIDS patients present initially w ith PCP. These are the classic sns & sxs of PCP pneumonia. While mycoplasma patients can be acutely ill, they are more likely (especially on the Boards) to present as mildly ill with normal PE and no hypoxia. S. pneumo is the most common CAP, but would present with a focal/lobar consolidation.Question 27A patient describes a history of a "curtain being brought down over my right  eye it stayed there for a few minutes then was lifted back up." In which of  the following arteries is the etiology of this complaint located?Aanterior cerebralBmiddle cerebralC posterior cerebralDinternal carotidEexternal carotidQuestion 27 Explanation: This is amaurosis fugax....a form of "TIA" of the optic artery — it arises from the internal carotid - most common location for occlusion in TIA. Question 28Upon review of an EKG you notice periodic, repetitively absent QRS complexes and "grouped beating." Which of the following is the explanation?Athird degree heart blockHint: in third degree, there is no rhyme or reason to the rhythm.B Mobitz Type II heart blockHint: In Mobitz II, the PR intervals are the same - so no "grouped" beatingC Mobitz Type I heart blockDfirst degree heart blockEsinus tachycardiaQuestion 28 Explanation: I don't like the wording of this question, but typically "group beating" suggests Wenckebach. The fact that there are absent QRS complexes means there is a second or third degree AVB. In Mobitz II, the PR intervals are the same - so no "grouped" beating, in Third degree, there is no rhyme or reason to the rhythm. In Wenckebach, the rhythm "repeats", causing a "regularly irregular" rhythm.Question 29A 14 month-old female is brought to your office with a 3-day history of a fever of 104 degrees rectally. Suddenly, today, the fever stopped and a rash deve loped. Examination reveals a diffuse, fine, maculopapular rash. Presently, the child does not appear ill. The most likely diagnosis is:ArubellaHint: Rubella has mild illness with a fine macular rasBrubeolaHint: Rubeola (measles) is an acute illness, the child is toxic, has conjunctivitis and Koplik spots. Cerythema infectiosum (Fifth's disease) Hint: Fifth's disease has mild illness with a "lacey" rash on the extremities. DRoseolaEchicken poxHint: Chicken pox has vesicles.Question 29 Explanation: This is typical for Roseola. Rubella has mild illness with a fine macular rash. Rubeola (measles) is an acute illness, the child is toxic, has conjunctivitis and Koplik spots. Fifth's disease has mild illness with a "lacey" rash on the extremities. Chicken pox has vesicles.Question 30At what age does the first tooth usually erupt in an infant?A2-4 monthsHint: See B for explanationB6-8 monthsC 10-12 monthsD 14-16 monthsQuestion 30 Explanation: The first tooth in an infant to erupt is the central incisor at the average age of 6-8 months. Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results There are 30 questions to complete. List Return Shaded items are complete. 123456789101112131415161718192021222324252627282930End Return You have completed questions question Your score is Correct Wrong Partial-Credit You have not finished your quiz. If you leave this page, your progress will be lost. Correct Answer You Selected Not Attempted Final Score on Quiz Attempted Questions Correct Attempted Questions Wrong Questions Not Attempted Total Questions on Quiz Question Details Results Date Score Hint Time allowed minutes seconds Time used Answer Choice(s) Selected Question Text All doneNeed more practice!Keep trying!Close but no cigar!Good work! Fantastic!Perfect! You are amazing!

Humanity Bloomed During the Renaissance

The Renaissance, a movement that  stressed the ideas of the classical world, ended the medieval era  and heralded the start of Europes modern age. Between the 14th and 17th centuries, art and science flourished as empires expanded and cultures mixed as never before. Although historians still debate some  causes of the Renaissance, they agree on a few basic points. AHunger for Discovery The courts and monasteries of Europe had long been repositories of manuscripts and texts, but a change in how scholars viewed them sparked a massive reappraisal of classical works in the Renaissance. Fourteenth-century writer Petrarch typified this, writing about his lust for discovering texts that  had previously been ignored. As literacy spread and a middle class emerged, seeking out, reading, and spreading classical texts became commonplace. New libraries developed to facilitate access to old books. Ideas once forgotten were now reawakened, as was interest in their authors. Reintroduction of Classical Works During the Dark Ages, many classical European texts were lost or destroyed. Those that survived were hidden in churches and monasteries of the Byzantine Empire or in capitals of the Middle East. During the Renaissance, many of these texts were slowly reintroduced into Europe by merchants and scholars. In 1396 an official academic post for teaching Greek was created in Florence. The man hired, Manuel Chrysoloras, brought with him a copy of Ptolemy’s Geography from the East. A huge number of Greek texts and scholars arrived in Europe with the fall of Constantinople in 1453. The Printing Press The invention of the printing press  in 1440 was the game-changer. Finally, books could be mass produced for far less money and time than by the old handwritten methods. Ideas could be spread through libraries, booksellers, and schools in a way that wasnt possible before. The printed page was more legible than the elaborate script of books written longhand. Printing became a viable industry, creating new jobs and innovations. The spread of books also encouraged the study of literature itself, allowing new ideas to spread as cities and nations began establishing universities and other schools. Humanism Emerges Renaissance humanism  was a new manner of thinking and approaching the world. It has been called the earliest expression of the Renaissance and is described as both a product and a cause of the movement. Humanist thinkers challenged the mindset of the previously dominant school of scholarly thought, Scholasticism, as well as the Catholic Church, allowing the new thinking to develop. Art and Politics The new artists needed wealthy patrons to support them, and Renaissance Italy was especially fertile ground. Political changes in the ruling class shortly before this period had led to the rulers of most major city-states being â€Å"new men† without much political history. They attempted to legitimize themselves with conspicuous investment in and public flaunting of art and architecture. As the Renaissance spread, church and European rulers used their wealth to adopt the new styles to keep pace. The demand from the  elites wasn’t just artistic; they also relied upon ideas developed for their political models. The Prince, Machiavelli’s  guide for rulers, is a work of Renaissance political theory. The developing bureaucracies of Italy and the rest of Europe generated new  demand for highly educated humanists to fill the ranks of governments and bureaucracies. A new political and economic class emerged.   Death and Life In the middle of the 14th  century, the Black Death swept Europe, killing perhaps a third of the population. While devastating, the plague left survivors better off financially and socially, with the same wealth spread among fewer people. This was especially true in Italy, where social mobility was much greater. This new  wealth often was spent lavishly on arts, culture, and artisanal goods.  The merchant classes of regional powers such as Italy  saw a great increase in wealth from their roles in trade. This growing mercantile class sparked a financial industry to manage their wealth, generating additional economic and social growth. War and Peace Periods of peace and war have been credited with allowing the Renaissance to spread. The end of the Hundred Years War between England and France in 1453 allowed Renaissance ideas to penetrate these nations as resources once consumed by war were funneled into the arts and sciences. By contrast, the Great Italian Wars of the early 16th century allowed Renaissance ideas to spread to France as its armies invaded Italy repeatedly over 50 years.

Battle of Monmouth in the American Revolution

The Battle of Monmouth was fought on June 28, 1778, during the American Revolution (1775 to 1783). Major General Charles Lee  commanded 12,000 men of the Continental Army under the leadership of General George Washington. For the British,  General Sir Henry Clinton  commanded 11,000 men under the leadership of  Lieutenant General Lord Charles Cornwallis. The weather was extremely hot during the battle,  and almost as many soldiers died from heatstroke as from battle. Background With the French entry into the American Revolution in February 1778, British strategy in America began to shift as the war became increasingly global in nature. As a result, the newly appointed commander of the British Army in America, General Sir Henry Clinton, received orders to dispatch part of his forces to the West Indies and Florida. Though the British had captured the rebel capital of Philadelphia in 1777, Clinton, soon to be short on men, decided to abandon the city the following spring to focus on protecting his base at New York City. Assessing the situation, he originally wanted to withdraw his army by sea, but a shortage of transports compelled him to plan a march north. On June 18, 1778, Clinton began evacuating the city, with his troops crossing Delaware at Coopers Ferry. Moving northeast, Clinton initially intended to march overland to New York, but later opted to move toward  Sandy Hook and take boats to the city. Washingtons Plan While the British commenced planning their departure from Philadelphia, General George Washingtons army was still at its winter quarters encampment at Valley Forge, where it had been tirelessly drilled and trained by Baron von Steuben.  Learning of Clintons intentions, Washington sought to engage the British before they could reach the safety of New York. While many of Washingtons officers favored this aggressive approach, Major General Charles Lee strenuously objected. A recently released prisoner of war and an adversary of Washingtons, Lee argued that the French alliance meant victory in the long run and that it was foolish to commit the army to battle unless they had overwhelming superiority over the enemy. Weighing the arguments, Washington elected to pursue Clinton. In New Jersey, Clintons march was moving slowly due to an extensive baggage train. Arriving at Hopewell, NJ, on June 23, Washington held a council of war. Lee once again argued against a major attack, and this time managed to sway his commander. Encouraged in part by suggestions made by Brigadier General Anthony Wayne, Washington decided instead to send a force of 4,000 men to harass Clintons rearguard. Due to his seniority in the army, Lee was offered command of this force by Washington. Lacking confidence in the plan, Lee declined this offer and it was given to the Marquis de Lafayette. Later in the day, Washington enlarged the force to 5,000. Upon hearing this, Lee changed his mind and demanded that he be given command, which he received with strict orders that he was to hold a meeting of his officers to determine the plan of attack. Lees Attack and Retreat On June 28, Washington received word from the New Jersey militia that the British were on the move. Directing Lee forward, he instructed him to strike the flank of the British as they marched up Middletown Road. This would halt the enemy and allow Washington to bring up the main body of the army. Lee obeyed Washingtons earlier order and held a conference with his commanders. Rather than devising a plan, he told them to be alert for orders during the battle. Around 8 p.m. on June 28, Lees column encountered the British rear guard under Lieutenant General Lord Charles Cornwallis just north of Monmouth Court House. Rather than launch a coordinated attack, Lee committed his troops piecemeal and quickly lost control of the situation. After a few hours of fighting, the British moved to flank Lees line. Seeing this movement, Lee ordered a general retreat up the Freehold Meeting House-Monmouth Court House Road after offering little resistance. Washington to the Rescue While Lees force was engaging Cornwallis, Washington was bringing up the main army. Riding forward, he encountered the fleeing soldiers from Lees command. Appalled by the situation, he located Lee and demanded to know what had happened. After receiving no satisfactory answer, Washington rebuked Lee in one of the few instances in which he swore publicly. Dismissing his subordinate, Washington set to rallying Lees men. Ordering Wayne to establish a line north of the road to slow the British advance, he worked to establish a defensive line along a hedgerow. These efforts held off the British long enough to allow the army to take up positions to the west, behind the West Ravine. Moving into place, the line saw Major General William Alexanders men on the left and Major General Nathanael Greenes troops to the right. The line was supported to the south by artillery on Combs Hill. Falling back to the main army, the remnants of Lees forces, now led by Lafayette, re-formed to the rear of the new American line with the British in pursuit. The training and discipline instilled by von Steuben at Valley Forge paid dividends, and the Continental troops were able to fight the British regulars to a standstill. Late in the afternoon, with both sides bloodied and exhausted  from the summer heat, the British broke off the battle and withdrew toward New York. Washington wished to continue the pursuit, but his men were too exhausted and Clinton had reached the safety of Sandy Hook. The Legend of Molly Pitcher While many of the details regarding the involvement of a Molly Pitcher in the fighting at Monmouth have been embellished or are in dispute, it seems there was indeed a woman who brought water to American artillerymen during the battle. This would have been no small feat, as it was desperately needed not only to alleviate the mens suffering in the intense heat but also to swab the guns during the reloading process. In one version of the story, Molly Pitcher even took over from her husband on a gun crew when he fell, either wounded or from heatstroke. It is believed that Mollys real name was  Mary Hayes McCauly, but, again, the exact details and extent of her assistance during the battle is unknown. Aftermath Casualties for the Battle of Monmouth, as reported by each commander, were 69 killed in battle, 37 dead from heatstroke, 160 wounded, and 95 missing for the Continental Army. British casualties included 65 killed in battle, 59 dead from heatstroke, 170 wounded, 50 captured, and 14 missing. In both cases, these numbers are conservative and losses were more likely 500 to 600 for Washington and over 1,100 for Clinton. The battle was the last major engagement fought in the northern theater of the war. Thereafter, the British holed up in New York and shifted their attention to the southern colonies. Following the battle, Lee requested a court-martial to prove that he was innocent of any wrongdoing. Washington obliged and filed formal charges. Six weeks later, Lee was found guilty and suspended from the service.