This easy-to-use resource details all of the complications likely to be encountered in clinical practice. The scope has been expanded to include the critical care setting. Internationally renowned authorities explain the nature, likelihood, and causes of each problem, and then guide you through the appropriate treatment measures. Each type of complication is discussed in its own concise chapter making it easier to quickly locate and research specific topics of interest. Presents content in an updated, logical organization covering various types of complications (drugs, testing, intubation, line insertion, surgical procedures, etc.) followed by differential diagnosis and treatment of signs of complications (intraoperative, such as hypoxia or hypotension; and postoperative, such as MI). Follows a problem-based, practice-oriented approach throughout; case synopses are followed by concise coverage of recognition, risk assessment, implications, management, and prevention. Allows you to review the case reports, contemplate the implications, then check your response against what the experts have to say. Includes numerous photographs, diagrams, flow charts, and tables that illustrate key concepts. Ideal as a clinical reference and as a study tool when preparing for oral boards. Brings you up to date with new safety standards and the latest ASA guidelines. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.

This issue of Anesthesiology Clinics focuses on Anesthesia Out of the Operating Room. Editors Mark Weiss and Wendy Gross have assembled an expert team of authors on topics such as: A Changing Landscape: Demands of Integrated Care Delivery: Interventional Medicine and Anesthesiology: Engineering Challenges and Interdisciplinary Teamwork; Organizational Infrastructure: Attaining and Teaching Clinical Excellence. Improvement across specialties by implementing an "Institute" mentality in the clinical arena; Quality: Who's rules apply?; Electronic Health Records; Monitoring; Interventional Radiology (NOT RADIATION): (Safety/Tumor Ablation/Adult radiology/ equipment); Approaches to Vascular Disease; Cath Lab: Structural Heart Disease, Devices and TAVR; EP Lab; Cardioversions and TEEs; Upper GI EGD and new procedures; Colonoscopy and new procedures anesthesiologist and GI person; Endoscopic Surgery, repair of surgical procedures, bariatric procedures; Interventional Pulmonology; Pediatrics; Market Evaluation; Finances, Bundled Payments and ACOs; Competitive Strategy or Joint Venture Finance: potential threats and likely future scenarios.

This comprehensive text describes the origins, mechanisms, beneficial applications and practical details of frequency specific therapy - a treatment technique that uses frequencies, micro amperage current and the principles of biological resonance to treat pain and a wide range of medical conditions. It includes condition specific frequency protocols for the treatment of various pain complaints, and multi-center clinical case reports documenting successful application of the technique. Each section includes a review of condition pathophysiology and differential diagnosis, plus current research. A website http://booksite.elsevier.com/9780443069765 features a lecture from the author, practical demonstrations of techniques, fully searchable text and downloadable images from the book!

Pain is an inevitable part of existence, but severe debilitating or chronic pain is a pathological condition that diminishes the quality of life. The Brain and Pain explores the present and future of pain management, providing a comprehensive understanding based on the latest discoveries from many branches of neuroscience. Richard Ambron-the former director of a neuroscience lab that conducted leading research in this field-explains the science of how and why we feel pain. He describes how the nervous system and brain process information that leads to the experience of pain, detailing the cellular and molecular functions that are responsible for the initial perceptions of an injury. He discusses how pharmacological agents such as opiates affect the duration and intensity of pain. Ambron examines new evidence showing that discrete circuits in the brain modulate the experience of pain in response to a placebo, fear, anxiety, belief, or other circumstances, as well as how pain can be relieved by activating these circuits using mindfulness training and other nonpharmacological treatments. The book also evaluates the prospects of procedures such as deep brain stimulation and optogenetics. Current and thorough, The Brain and Pain will be invaluable for a range of people seeking to understand their options for treatment as well as students in neuroscience and medicine.

If you are a serious runner, you are well aware of the aches and pains associated with the sport. Run Healthy: The Runner’s Guide to Injury Prevention and Treatment was written to help you distinguish discomfort from injury. It provides the latest science-based and practical guidance for identifying, treating, and minimizing the most common injuries in track, road, and trail running. Gain a better understanding of how the musculoskeletal system functions and responds to training. Develop a practical and effective training plan to address the regions where injuries most often occur: feet and toes, ankles, knees, hips, and low back. Learn how a combination of targeted strength training, mobility exercises, and running drills can improve running form, economy, and performance. When injuries inevitably happen, you’ll know how to identify them, treat them, and recover from them. Get targeted recommendations for some of the most common issues runners face, such as plantar fasciitis, Achilles tendinitis, shin splints, hamstring tendinitis and tendinopathy, and IT band syndrome. Throughout, you’ll hear from 17 runners on how the techniques in this book helped them overcome their injuries and got them quickly and safely back to training and racing. You’ll also find an in-depth discussion of alternative therapies such as acupuncture, cupping, CBD, cryotherapy, and cleanses to help you separate fact from fiction and decide for yourself which, if any, of these therapies to pursue. Injuries can and do happen, but with Run Healthy you’ll be running strong for many years to come. Earn continuing education credits/units! A continuing education exam that uses this book is also available. It may be purchased separately or as part of a package that includes both the book and exam.

Cardiac Anesthesia: A Problem-Based Learning Approach provides a comprehensive review of the dynamic and ever-changing field of cardiac anesthesia. Its problem-based format incorporates a pool of multiple-choice questions for self-assessment. Each of its 36 case-based chapters is accompanied by questions and answers, accessible online in a full practice exam. The cases presented are also unique, as each chapter starts with a case description, usually a compilation of several actual cases; it then branches out through case-based questions, to increasingly complex situations. This structure is designed to create an authentic experience that mirrors that of working through the nuances of a complicated clinical scenario. The discussion sections that follow offer a comprehensive approach to the chapter's subject matter, thus creating a modern, complete, and up-to-date medical review of that topic.

Pain medicine has struggled to find effective treatments for chronic pain. Opioids, which were considered the standard of care, have now demonstrated to have significant adverse long-term consequences. This book provides the reader with pain treatment strategies that have been effectively employed over the years as well as the newest trends and treatment in pain care. Covers cannabinoids in pain care, novel therapeutics in pain medicine, and integrative care in pain management. Discusses relevant basic science, psychological aspects of pain care, opioids and practice guidelines, geriatric pain management, and future research in the field. Consolidates today's available information and guidance into a single, convenient resource.

Named a 2013 Doody's Core Title 2012 Third Place AJN Book of the Year Award Winner in Psychiatric-Mental Health Nursing

"This is a great resource for any nurse working with women."--Score: 94, 4 Stars. Doody's Medical Reviews

This is a quick-access clinical guide to the range of mental health issues and diagnoses that commonly affect women across the life span. It focuses on the unique biopsychosocial factors that make women especially vulnerable to psychological disorders and emphasizes key stressors specific to women that are precursors to mental illness. Frequent headings and bulleted, concise presentation of information facilitates reading.

In addition to discussing mental health issues specific to women, the guide covers unique populations such as disabled women, lesbian and transgendered women, female veterans, women with forensic health concerns, and women who have been the object of violence. Chapters also address childbearing issues, including menstruation-related problems, infertility and its psychological implications, and antepartum, intrapartum, and postpartum psychological disorders. Developmental milestones, the impact of culture on mental illness, and global health issues are covered as well. Tables and charts present key facts in an easy-to-read format. Key Features:

Provides a concise, easy-to-use guide to women's mental health issues across the life span for new and seasoned nurse practitioners Focuses on stressors unique to women as precursors of mental illness Delivers commonly occurring DSM-IV disorders in women, using a consistent format that includes etiology, assessment, and drug and behavioral therapeutic approaches Discusses preconception and childbearing issues, the impact of violence, female veterans, disabled women, lesbian women, and transgendered women

Chronic pain affects every aspect of life-physical well-being, mood, stamina, and feelings of self worth and self respect. This book focuses on conquering pain and its related problems through proper management. It offers numerous tools and concepts with which to attack chronic pain and win the battle that more than 35 million people in the U.S. alone fight every day. Virtually all specialists in the health care field must be concerned with pain management-this complete reference offers them strategies for helping their patients, and for patients to help themselves.
Chronic Pain: Assessment, Diagnosis, and Management presents a variety of therapies for combating chronic pain, including:
o Applying external therapy
o Changing the way patients perceive pain through psychotherapy or other cognitive means
o Physical therapy and exercises
o Over-the-counter or prescription medicines to relieve pain, stress, and insomnia caused by discomfort
o Surgical options
The book also contains never before published information on how to prescribe and administer opioids and opioid-containing analgesics for chronic, intractable, and non-malignant pain patients.
There is hope for those suffering from chronic pain. This book outlines commonly overlooked problems that, if properly addressed, can make the difference between a patient recovering or effectively managing their pain-or not. Chronic Pain: Assessment, Diagnosis, and Management is full of practical advice and options for anyone suffering from chronic pain and for the doctors who treat them.

Concerned with practices in palliative care, this text focuses on the psycho-social aspects of palliative care as opposed to the medical and nursing dimensions. Beginning with a framework of the interdependence of all aspects which is characteristic of the holistic nature of the subject, the book is intended to help readers identify the principles which underpin good practice in the non-medical dimensions in palliative care. The book caters for the professional reader and should be relevant to nurses, doctors, physiotherapists, occupational therapists and managers, as well as social workers undertaking professional training and working in palliative care.

Pain and Its Relief Without Addiction will help people in pain understand why their pain is not always adequately relieved, as well as help reverse the failure of current medical practice to routinely alleviate pain. As noted by a 1992 publication of the United States Department of Health Services, this devastating trend contributes to unnecessary discomfort, longer recovery periods, and compromised patient outcomes. By reading this book, frustrated physicians and, perhaps more importantly, persons in pain can acquire a better understanding of the nature of pain, its connection to the emotions and psychological state of patients, and the impact particular drugs have on the body; this will facilitate relief from pain among a higher percentage of the population.Opioid analgesics comprise many of the chapters in Pain and Its Relief Without Addiction. Author Barry Stimmel, MD, describes the principles to be followed in prescribing opioid analgesics to relieve pain while maintaining one s daily activities without any limitation in function. The available opioids are described, and the differences between them are reviewed to allow you--as a physician, health care provider, or even a patient--to gain a better insight into the one(s) to use for both acute and chronic pain states. The point that is emphasized is that dependency on an analgesic to relieve pain is no different than dependency on medications to lower blood pressure, prevent heart attacks, treat diabetes, etc. What should be avoided is "addiction," a condition where function is impaired rather than enhanced.Pain and Its Relief Without Addiction is a guidebook designed to assist physicians and other health professionals in developing a practical approach to pain management and to give patients a fuller understanding of their pain. You ll gain specific information about: management of acute and chronic pain pain in children pain and cancer pain and AIDS psychological support of persons in pain theories of pain perception the anatomy of painIn Pain and Its Relief Without Addiction, you ll learn the basic concepts of drug dependence, tolerance, and withdrawal, the pharmacological actions and side effects of drugs used to provide analgesia, and the fundamental steps to be taken in proper pharmacological treatment of pain. The book produces more effective and more informed communication among physicians, other health professionals, and patients so that together they can achieve better pain relief. As Pain and Its Relief Without Addiction illustrates, it is crucial that both patients and physicians understand clearly the terms describing drug use and the behavioral, biochemical, and cellular concepts underlying dependence, tolerance, and withdrawal. Finally, you will acquire a knowledge of all the potential causes of pain and the appropriate steps for intervention.Medical students, new practitioners, and those wishing to reconsider their approaches to pain management will benefit from the book s coverage of general principles for pain control, the use of drug combinations to provide the most effective relief, methods for treating pain in different populations (such as the elderly and persons with chronic medical conditions), and alternative options for failed treatment. The scope of Pain and Its Relief Without Addiction reaches from nonprescription medications, such as aspirin, to NSAIDS, like ibuprofen, to narcotic analgesics to stimulants such as amphetamines and caffeine. It is the most comprehensive book available on various drugs, their desired effects and side effects, and their use to alleviate pain.

Pain and Its Relief Without Addiction will help people in pain understand why their pain is not always adequately relieved, as well as help reverse the failure of current medical practice to routinely alleviate pain. As noted by a 1992 publication of the United States Department of Health Services, this devastating trend contributes to unnecessary discomfort, longer recovery periods, and compromised patient outcomes. By reading this book, frustrated physicians and, perhaps more importantly, persons in pain can acquire a better understanding of the nature of pain, its connection to the emotions and psychological state of patients, and the impact particular drugs have on the body; this will facilitate relief from pain among a higher percentage of the population.Opioid analgesics comprise many of the chapters in Pain and Its Relief Without Addiction. Author Barry Stimmel, MD, describes the principles to be followed in prescribing opioid analgesics to relieve pain while maintaining one s daily activities without any limitation in function. The available opioids are described, and the differences between them are reviewed to allow you--as a physician, health care provider, or even a patient--to gain a better insight into the one(s) to use for both acute and chronic pain states. The point that is emphasized is that dependency on an analgesic to relieve pain is no different than dependency on medications to lower blood pressure, prevent heart attacks, treat diabetes, etc. What should be avoided is "addiction," a condition where function is impaired rather than enhanced.Pain and Its Relief Without Addiction is a guidebook designed to assist physicians and other health professionals in developing a practical approach to pain management and to give patients a fuller understanding of their pain. You ll gain specific information about: management of acute and chronic pain pain in children pain and cancer pain and AIDS psychological support of persons in pain theories of pain perception the anatomy of painIn Pain and Its Relief Without Addiction, you ll learn the basic concepts of drug dependence, tolerance, and withdrawal, the pharmacological actions and side effects of drugs used to provide analgesia, and the fundamental steps to be taken in proper pharmacological treatment of pain. The book produces more effective and more informed communication among physicians, other health professionals, and patients so that together they can achieve better pain relief. As Pain and Its Relief Without Addiction illustrates, it is crucial that both patients and physicians understand clearly the terms describing drug use and the behavioral, biochemical, and cellular concepts underlying dependence, tolerance, and withdrawal. Finally, you will acquire a knowledge of all the potential causes of pain and the appropriate steps for intervention.Medical students, new practitioners, and those wishing to reconsider their approaches to pain management will benefit from the book s coverage of general principles for pain control, the use of drug combinations to provide the most effective relief, methods for treating pain in different populations (such as the elderly and persons with chronic medical conditions), and alternative options for failed treatment. The scope of Pain and Its Relief Without Addiction reaches from nonprescription medications, such as aspirin, to NSAIDS, like ibuprofen, to narcotic analgesics to stimulants such as amphetamines and caffeine. It is the most comprehensive book available on various drugs, their desired effects and side effects, and their use to alleviate pain.

Millions of people suffer through day after day of chronic pain, and if you are among them, Marlene Hunter, M.D. provides a powerful new approach to controlling its impact on your life. Making Peace with Chronic Pain is neither a book of magic tricks nor quick fixes. What it does offer you are realistic and effective plans for dealing with pain. The author lays out a comprehensive strategy to cope with pain in several stages: Identification, Modification, Lifestyle changes, Medications, and Pain relief techniques. Taken together, this is a whole-life strategy to help chronic pain sufferers regain some control of their health and redirect their efforts to make peace with their chronic pain - and move on.

Pain is a personal experience, which everyone encounters at some time, that for some unfortunate individuals becomes a permanent factor in their quality of life and clinical treatment. This is the first book to provide a comprehensive, integrated and accessible account of the experience of pain and its implications. It was written for psychologists, doctors, therapists, counsellors, and nurses in both academic and treatment settings. The experience of pain is examined at all stages from first symptoms of pain and how they relate to personal, social and cultural beliefs and attitudes, through the consultation and treatment process, personal coping, and the effects of pain on patient and carers. At every stage the discussion is based on relevant psychological concepts and a review of the latest research. The book provides an integrated, multidisciplinary account of cognitive, biological and social aspects of pain. An emphasis on social psychological processes leads to a new model of pain that will enlighten both teaching and treatment and guide further research. Accounts of pain often deal with specific, specialised aspects but many students and healthcare professionals need a wider, more person-centred understanding of pain, and will find this book a valuable resource and guide to the experience of pain and its implications for treatment and coping.

It has been around since the first rear-impact automobile accident and it will continue to be a problem as long as humans have large, heavy heads perched on slender, highly mobile cervical spines. The subject is whiplash, and some of the brightest minds on the topic gathered in Banff, Alberta, Canada, for the Eighth International Symposium by the Physical Medicine Research Foundation. Editor Dr. Murray E. Allen, Chairman of the Symposium, has collected the findings in Musculoskeletal Pain Emanating From the Head and Neck: Current Concepts in Diagnosis, Management, and Cost Containment to help physicians, physical therapists, chiropractors, and researchers better understand "the new whiplash," make reliable clinical assessments, and provide more effective treatment.This thorough collection includes bump studies with human volunteers, research into safer automobile seat backs and head restraints, postmortem cervical spine examinations, reviews of the literature, and other investigations from around the world. Readers of Musculoskeletal Pain Emanating From the Head and Neck will learn specifically about: injury mechanisms, threshold for injury, and impact severity long-term outcomes of whiplash injury psychological aspects of chronic pain and disability dizziness, imbalance, and chronic incapacity intervertebral joint injuries and cervical synovial joint injuries the Neck Disability Index manipulation and mobilization therapies temporomandibular disorders/temporomandibular pain and dysfunction syndrome (TMPDS)Musculoskeletal Pain Emanating From the Head and Neck is not simply a collection of studies presenting data and findings--rather, it is a compilation of knowledge that illuminates the challenges of treating whiplash and makes some strong and straightforward recommendations for improvement. The contributors and the editor stress to the reader that in order to provide the best possible care, providers must be alert to the many secondary manifestations of whiplash, test for the perception of dysfunction, and be reassuring whenever possible. They must foster an atmosphere of confidence, encourage very early activation, and help persons maintain the momentum of their lives. Furthermore, Dr. Allen calls for caregivers to stop most (if not all) drug treatments, avoid passive failure-mode treatments, and avoid prolonged medicalization of any form of treatment. By studying the findings and following the recommendations of the international experts contributing to Musculoskeletal Pain Emanating From the Head and Neck, physicians, chiropractors, and physical therapists will foster self-reliance in their patients and improve diagnosis, treatment, and cost containment of whiplash.

Audit was a buzz word of the late '80s and early '90s, but in anaesthetic practice the important issues are quality of service and safety of the patient and audit is used to monitor and agree standards for these two.
With contributions from leading figures in anaesthetic audit, "Quality and Safety in Anaesthesia" describes the important work already done and addresses vital aspects such as risk management, resource management, standards and postgraduate training, critical incidents and human error, use of computers, design of equipment for safety and managing a department of anaesthesia.
This book relates the process of quality assurance to the drive to improve the quality of anaesthetic practice. It should be useful for all those working or thinking about working in anaesthetic departments, and will be revealing to all those with an interest in quality and audit.

Fully updated in a new, contemporary edition - the bestselling guide to cider vinegar, and its role in reducing pain and improving mobility.

Hundreds of thousands of people with arthritis have been helped by the Margaret Hills Clinic and by Margaret's bestselling book, Treating Arthritis: The Drug-free Way. Cider vinegar is a cornerstone of the treatment protocol, and this companion title has been completely updated with all-new recipes featuring this amazing natural product, in addition to suggesting a wide variety of other uses, all of which can help to reduce arthritic pain and joint stiffness.

Embracing the simple principles that make this drug-free protocol so effective, this book will help you to make cider vinegar a regular part of your daily diet, and offer insight into just why it is so effective. In addition to reducing inflammation and improving mobility, cider vinegar can aid with weight loss - it can also replace many of the chemically-derived products in your home, or in your personal care routine, making your environment a healthier and potentially much less toxic one.

The very many recipes in this book all feature the wonder ingredient that is cider vinegar, and they all cater for vegetarians and vegans. There are recommendations for those managing auto-immune conditions such as coeliac disease, or food allergies, and the emphasis throughout is on fresh, raw, local ingredients.

Cider Vinegar complements Margaret Hills' renowned Treating Arthritis programme to offer gentle, natural and manageable steps to reduce pain and improve mobility.

Palliative care provides comprehensive support for severely affected patients with any life-limiting or life-threatening diagnosis. To do this effectively, it requires a disease-specific approach as the patients' needs and clinical context will vary depending on the underlying diagnosis. Experts in the field of palliative care and oncology describe in detail the needs of patients with advanced cancer in comparison to those with non-cancer disease and also identify the requirements of patients with different cancer entities. Basic principles of symptom control are explained, with careful attention to therapy for pain associated with either the cancer or its treatment and to symptom-guided antineoplastic therapy. Complex therapeutic strategies for palliative cancer patients are highlighted that involve both cancer- and symptom-directed options and address a range of therapeutic aims. Issues relating to drug use in palliative cancer care are fully explored, and a separate section is devoted to care in the final phase. A range of organizational and policy issues are also discussed, and the book concludes by considering likely future developments in palliative care for cancer patients. Palliative Care in Oncology will be of particular interest to palliative care physicians who are interested in broadening the scope of their disease-specific knowledge, as well as to oncologists who wish to learn more about modern palliative care concepts relevant to their day-to-day work with cancer patients.

This book deals with the management of labour, guiding the readers to recognize problems by keen monitoring, based on anatomical and physiological understanding of labour. In this era of technology, this book revives the fading art of identification of clinical signs and symptoms. The chapters are well-structured, covering different aspects from suspicion to identification of the problems by recognizing subtle warning signals by the fetus and the uterus. Operative deliveries and common obstetric emergencies with their appropriate management are also covered. It provides practical points to prevent, anticipate, recognize, and manage problems during labour. Key Features Helps to identify clinical signs and symptoms that infuses the reader with confidence to identify and manage abnormal situations during labour and childbirth through the feel of their fingers and awakened understanding. A must have book for all postgraduate trainees and practitioners of obstetrics, eager to learn the fundamentals of labour management. Features illustrated cases helpful in learning management of normal labour and pick abnormal labour, at the earliest possible deviation from normalcy.

There have been many developments in anaesthesia since Joseph Priestley discovered nitrous oxide. Covering new anaesthetics, the molecular and cellular mechanisms of anaesthesia and the non-hypnotic effects of anaesthetics and other medical gases, Gases in Medicine combines reviews of current research from both academic and clinical perspectives and provides an historical framework in which this research may be placed. Encompassing a wide range of topics including intravenous anaesthetics, neural processes and the 1997 Priestley Lecture on nitric oxide, this book offers an accessible summary of anaesthesia along with the current best research. Also included is the BOC Centenary Lecture, which gives a perspective on anaesthesia for the 21st century. This book will be welcomed by readers in academia and medicine as an illustration of the diversity of research into anaesthesia and the associated history of this fascinating subject.

A collection of 25 thought provoking Essays which create a bridge between the Classical personification of values and link them to current training and education in Western Medicine. This readable and erudite text provides a framework for modern clinical values - with a particular emphasis on anesthesiology - set in the context of ageless dilemmas facing each generation of physicians. Medicine as a profession carries some specific obligations.The qualities of empathy, knowledge, generosity, respect, and scholarship provide a "family" of values that was personified by the Ancients in the family of Asklepios, and which form the basis of professional values today. Moreover, a substantial amount of professional growth should come from reflection based on the experience of caring for real patients - an appreciation of the human condition. Each essay within this beautifully crafted book illustrates the importance of expertise, skill, focus, mindfulness, and collaboration, all of which are integral to professionalism in medicine, and in particular to those working in the field of anesthesiology. Anesthesiologists, Certified Registered Nurse Anesthetists and Anesthesia Assistants will find much to enhance their professional understanding within this text. The principles, values and traits of professionalism are relevant to all medical specialties and these essays provide a lyrical understanding of the traits required for professional development.

Linking existing knowledge to new knowledge by presenting it in the form of a case or a problem is a popular and effective educational approach resulting in better retention of the knowledge and improved ability to apply that knowledge to solve real problems. This problem-based learning (PBL) method was introduced into medical education at McMaster University in Ontario, Canada, in 1969. Since then it has been widely incorporated into secondary, undergraduate, and graduate education in a variety of disciplines worldwide. This new volume for the Anesthesiology Problem-Based Learning series reviews topics in general anesthesiology utilizing the PBL approach. Each chapter deals with conditions and problems in anesthesia practice presented as a case stem with questions to encourage critical thinking, followed by an evidence-based discussion and multiple-choice questions for self-assessment. Current in its knowledge of organ systems and management, the text keeps pace with new technology, new drugs, and new surgical techniques coupled with current guidelines for anesthetic management. Cases highlight the practical issues that arise in the operating room and offers solutions for them. The book can be used to review an upcoming clinical case or as a PBL tool. The 'Stem Case' and 'Key Questions and Discussion' sections can serve as the basis for interactive learning experiences for study groups or as a broad yet in-depth clinical review of the specialty for the individual learner. Self-assessment questions can be used as a measure of knowledge acquisition or simply as a question bank to prepare for examinations.