It happens all the time: good employees get a promotion, and suddenly, they're not so good anymore. Such is the case for cat shelter Paws Need Families, as Della, a cleaner turned assistant manager, then manager started arriving late, letting applications sit, and slipped on inoculations, all serious offenses. Instead of confronting Della directly, general meetings were held, and an assistant manager was hired to compensate for Della's shortcomings. Ultimately, Della never cleaned up her act, and was fired. Ken Blanchard, co-author ofThe One Minute Managerbelieves this situation could have been avoided with frequent meetings and support with a system of review, both of which can identify issues before they become real problems.

31 What are uraemic frost conditions?

32 What is the role of terlipressin or novapressin in the management of hepatorenal syndrome?

33 What is the rationale of angiotensin-converting enzyme (ACE) inhibitors in chronic renal disease?

34 What procedure is recommended for post renal transplant if this is the second graft?

35 Do the cysts in autosomal-dominant polycystic kidney disease (PCKD) undergo malignant transformation and in what percentage?

36 In a 69-year-old patient with a 2-cm hard prostatic nodule on digital rectal examination, what is the more appropriate way to make a definitive diagnosis of prostate cancer: prostate biopsy or serum prostatespecific antigen (PSA)?

37 A 50-year-old patient complains from slight lower urological symptoms (mild difficulty in urination). By digital rectal examination a mass of (1) hypertrophy can be palpated. His family history contains cases of prostate cancer (in some relatives). What is the next investigation to do in this patient? Titration of serum prostate-specific antigen (PSA): Is it useful in such a patient? Why? Transrectal ultrasound (TRUS)? TRUS-guided needle biopsy?

38 What are the causes of urinary incontinence in the elderly?

39 For how long could urinary retention persist after major gastrointestinal tract surgery? Will cholinesterase inhibitors be of benefit in enhancing emptying of the bladder?

40 1. What are the possible causes of a large, white kidney? 2. What is the physiological significance of a giant cell?

41 What is the amount of 24-hour urinary albumin excretion above which a diabetic patient is said to have microalbuminuria?

42 How is forced diuresis induced in cases of prerenal failure?