With plans devised and presentations pulled together, it's time to deliver the best ideas to upper management or the board for their consideration. Often, more than one idea will be presented at a time so the deciding group can consider and compare alternatives. Each alternative should be consistently presented with fair representation across each choice.

Value engineering calls for enhancing the value of each product; therefore, presentations should begin and end with how the change will benefit the company. Presentations should also include revised timelines, financial projections, drawings, and risks. Often, management may seek specific answers on changes or desire to see different analysis performed than what is presented.

Question 3 I have been taught to examine vocal resonance by asking the patient to say 'ninety-nine' while auscultating. I listen for a louder 'ninety-nine' over an area of consolidation and more quiet sounds with effusion. Is this right?

Question 4 What role does bupropion play in giving up smoking?

Question 5 The clinical signs and symptoms of rhinitis are very similar to those of the common cold (influenza). How do I differentiate between the two?

Question 6 What is the advantage of the drugs des-loratidine and levo-cetirizine over their parent compounds? Are they safe in pregnancy and lactation?

Question 7 What are the differences between acute bronchitis and pneumonia? Are both diseases caused by infection? 156 14 Respiratory diseaseRespiratory disease 14 157

Question 8 1. If a patient with chronic bronchitis develops obstructive jaundice and Escherichia coli biliary sepsis, should the routine administration of oral steroids (e.g. prednisolone) be suspended until liver function improves? 2. Are there any adverse reactions that preclude the concurrent use of steroids while the patient is treated with IV ciprofloxacin, gentamicin, metronidazole and cefuroxime?

Question 9 Robbins Basic Pathology mentions that in patients with chronic obstructive pulmonary disease (COPD), the forced ventilation capacity (FVC) is either normal or slightly increased! I just can't justify that. I mean it should decrease. And this is exactly what is mentioned in your book. I couldn't contact the authors of that book so I decided to ask you whether there is actually a situation in which the FVC in COPD patients might increase?

Question 10 Is there any obstructive pulmonary condition in which there might be an increase in FVC? If so by what mechanism? Question 11 I am confused whether clubbing is a feature of chronic obstructive pulmonary disease (COPD) or not - you have mentioned that it is not a feature of COPD but some books do say that clubbing is a clinical feature of COPD. Question 12 A 70-year-old man with chronic obstructive pulmonary disease (COPD) and a past history of myocardial infarction with a left ventricular ejection fraction (LVEF) of 25% is dyspnoeic on slight exertion such as walking, bathing. He is not orthopnoeic and claims to have no paroxysmal nocturnal dyspnoea (PND). He has no wheezing or productive cough and his blood pressure is normal. He has had three episodes of ventricular tachycardia (VT) and has been on amiodarone for the past year. What is the best way to determine the exact cause of dyspnoea in this case? Question 13 In bronchiectasis, what is the reason for using a bronchodilator if the airways are already dilated?