Answer: check her medical history to see if she has had these issues before during your physical exam alway check above and below the area the patient is complaining about. So for sinuses palpate the sinus drainage passage with the digits of your fingers. For below palpate the back of the neck ask if there’s any tenderness or pain also examine the throat and check the lymph nodes and tonsils. Do an oral exam look at the tonsils tongue teeth look for any inflammation or redness. Look in the nasal cavity to see if you see a deviated septum dryness bleeding any blockage after a full physical exam like that order your x-ray which would typically not be done on an acute patient with these symptoms but in a patient with chronic issues continuing I would immediately get a consult to a specialist which in her case would be an ENT( ears,nose,throat). A simple clinical treatment for sinus issues would to just put the patient on a antihistamine some examples are (Benadryl, Allegra and Clara tin) I’d recommend the patient follow up within a week to see if that helped at all and then if not follow through with the plan I set in place above. If you do place the patient on an antibiotic I would recommend (amoxicillin).
The focus on the word swarming has allowed the comparison with the bees. We say bees swarm but we do not say that a person swarms - in this way you can make a metaphor.
The comparison in personification on the other hand can be remembered by the word found in the first six letters -person
Cholesterol desmolase, also known as side-chain cleavage enzyme catalyzes the conversion of <em>cholesterol into pregnenolone</em>, which is the limiting step in steroid synthesis.
This enzyme is of the family cytochrome P450, the specific gene for this enzyme is CYP11A1.
