Kill or CURE (Destroyer, Book 11) by Warren Murphy, Richard Sapir
By Warren Murphy, Richard Sapir
CURE's undertaking is at risk, its secrets and techniques near to being printed. As a precaution, Remo and Chiun were break away with no aid, with out assets, with out oversight. Remo has a unmarried week to plug the leak, silence the competition and bury the our bodies, or Smith should pull the plug. complicated difficulties call for more and more inventive strategies: this time, the Destroyer must dip his feet within the shark-infested waters of Florida politics!
Remo Williams is The Destroyer, a doubtless unremarkable beat cop recruited—through hugely unorthodox methods—by a mystery executive law-enforcement association. educated to develop into the main lethal murderer, Remo is America's final defensive line opposed to mad scientists, prepared crime, historic undead gods, and the rest that threatens the structure. An action-adventure sequence leavened with social and political satire, the Destroyer novels were exciting readers world wide for decades.
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Additional info for Kill or CURE (Destroyer, Book 11)
Possible causes of physiological vaginal discharge are: • • • • Vestibular gland secretions. Vaginal transudate. Cervical mucus. Residual menstrual fluid. Don’t forget to reassure the patient that vaginal discharge might simply be physiological, related to the menstrual cycle or to pregnancy. Pathological causes need to be excluded. The differential diagnoses of pathological vaginal discharge are shown in Fig. 1. The most common group is the infections. History to focus on the differential diagnosis of vaginal discharge The patient should be asked about the nature of the discharge.
2 refer to miscarriage. The term ‘miscarriage’ is used in preference to ‘abortion’ which many women will equate with a termination. History for Bleeding/Pain in Early Pregnancy Last menstrual period The first day of the last menstrual period (LMP) will allow you to calculate the gestation. This becomes important when interpreting early pregnancy scans. While an empty uterus on a scan at 7 weeks might indicate an ectopic pregnancy, a small gestation sac with no fetal pole is common at 5 weeks. However, it is important to establish whether the woman is sure of her dates and whether her cycle is regular; if not, the estimated gestation may be wrong.
Inflammation. Ulceration. Foreign bodies. Local tumours. Bimanual pelvic examination will reveal pelvic tumours. It might also elicit tenderness and cervical excitation, suggesting PID. 2 Investigations for vaginal discharge Investigation Cause of discharge • Microbiological swabs (vulval/high vaginal/ endocervical/urethral). • MSU specimen. • Cervical cytology/biopsy. • Endometrial sampling/hysteroscopy. • Pelvic ultrasound scan. • Laparoscopy. 2 shows the relevant investigations for vaginal discharge.