Wgdcbgc [cvdcwcr 7ra \ulrtcr

@CWWEB <8 BC[VESW WTWQCM _lrts ef tjc GBW

BC[VESW WTWQCM L. K[LDB

-  Qjc bcrveus systcm rcgcdvcs 

rcgcdvcs   lba •  gemprdsca ef kd``debs ef
[c`lys  dbfermltdeb lkeut lgtdvdtdcs
[c`lys  dbtcrgebbcgtca bcurebs lba
wdtjdb tjc keay lba mebdters lba n`dl
rcspebas te Dbtcrbl`   lba Cxtcrbl`  
Gjlbncs.

Fubgtdebs ef tjc ; Jl`vcs ef tjc Gcrckrum

Bcurebs

-  spcgdl`dzca gc``s tjlt glrry mcsslncs

tjreunjeut tjc bcrveus systcm
-  Dt ds tjc klsdg fubgtdebdbn ubdt ef tjc
Bcrveus Wystcm

1 FSBGQDEBW8

  Wcbsery Fubgtdeb  - Nltjcrs dbfermltdeb

dbfermltdeb  
ketj frem tjc eutsdac wer`a lba frem
dbsdac tjc keay.
  Qrlbsmdts tjc dbfermltdeb
dbfermltdeb   te tjc
pregcssdbn lrcl ef tjc krldb lba spdbl`
gera.
  Dbtcnrltdvc Fubgtdeb  - _regcsscs tjc
dbfermltdeb  te
dbfermltdeb  actcrmdbc tjc kcst Advdsdeb ef tjc Krldb
rcspebsc

 Meter Fubgtdeb  - Wcbas dbfermltdeb 
dbfermltdeb  te
musg`cs, n`lbas, lba ernlbs se tjcy glb
rcspeba gerrcgt`y. Musgu`lr gebtrlgtdeb
er n`lbau`lr scgrctdebs.

; MLHE[ ADVDWDEBW

<. QJC GCBQ[L@ BC[VESW WTWQCM (GBW)

-  [c`lys mcsslncs, pregcsscs

<. Ferckrldb
dbfermltdeb, lba gemplrcs lba
lbl`yzcs dbfermltdeb   Qc`cbgcpjl`eb (Gcrckrum)
(Gcrckrum)  
-  Dt gebsdst ef tjc krldb lba tjc spdbl` -  Gebsgdeus tjeunjt pregcsscs,
gera dbtc``cgtul` fubgtdebs
-  Mcmery sterlnc lba
pregcssdbn
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

-  Gebsgdeus lba Wukgebsgdeus Fubgtdebs ef tjc Adffcrcbt _lrts ef tjc

rcnu`ltdeb ef sic`ctl` musg`c Krldb
gebtrlgtdeb.
   Adcbgcpjl`eb
Qjl`lmus   ‗ rc`ly lba pregc-
ssdbn gcbtcrs fer scbsery
dbfermltdeb.

Jypetjl`lmus   ‗  Gcbtcrs

gebtre``dbn cmetdebs, lute-
bemdg fubgtdebs, lba jerm-
ebc preaugtdeb.

;. Mdakrldb

   Mcscbgcpjl`eb (Mdakrldb)
(Mdakrldb)  
@ekcs ef tjc Krldb
-  _regcssdbn ef Vdsul` lba
Luadtery altl.
-  Ncbcrltdeb ef rcf`cxdvc seml-
tdg meter rcspebscs.

7. Jdbakrldb


  Mctcbgcpjl`eb
(Gcrckc``um)
-  Geeradbltcs gemp`cx semltdg
meter plttcrbs
-  Lahust eutput ef etjcr
semltdg meter gcbtcrs db tjc
krldb lba spdbl` gera. K. W_DBL@ GE[A
(_ebs)
-  [c`lys scbsery dbfermltdeb te
gcrckc``um lba tjl`lmus
-  Wukgebsgdeus Wemltdg lba
Vdsgcrl` meter gcbtcrs.
   Myc`cbgcpjl`eb
Myc`cbgcpjl`eb (Mcau``l
 (Mcau``l
Ek`ebnltl)
-  [c`lys scbsery dbfermltdeb te
tjl`lmus
-  Lutebemdg gcbtcrs fer
rcnu`ltdeb ef vdsgcrl` fubg-
tdebs sugj ls glradevlsgu`lr,
rcspdrltery, ctg.
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

;. _C[D_JC[L@ BC[VESW WTWQCM QT_CW EF BCS[EBW

-  gebbcgts tjc gcbtrl` bcrveus systcm te <. Wcbsery Bcureb

tjc ernlbs lba etjcr keay plrts
  [cgcpter
Wukadvdsdebs   krdbn mcsslncs te GBW

  lffcrcbt bcureb
l)  Wcbsery Advdsdeb  - glrrdcs dbfe te tjc
krldb lba spdbl` gera. ;. Meter Bcureb
k)  Meter Advdsdeb -  glrrdcs dbfe frem tjc

krldb te tjc keadcs cffcgters (tjdbns tjlt   Glrry dmpu`scs frem tjc krldb lba spdbl`
gera te MSWG@CW er N@LBAW.
ae tjc weri)
  Musg`cs gebtrlgt
  N`lbas scgrctc
   Wemltdg bcrvcs
bcrvcs   rc`ly gemmlbas te
  cffcrcbt bcureb
lba frem sic`ctl` musg`c (VE@SBQ-
L[T GEBQ[E@)  7. Dbtcrbcureb
_lrts8
<.  Wpdbl` Bcrvcs spdbl` gera lba   Gebbcgts scbsery & meter bcurebs
  Feuba cbtdrc`y wdtjdb tjc Gcbtrl`
keay
;.  Grlbdl` Bcrvcs  krldb stcm

Bcrveus Wystcm

    Lutebemdg bcrvcs
bcrvcs scba
 scba sdnbl`s te
lba frem smeetj musg`cs
(DBVE@SBQL[T GEBQ[E@) 
Wukadvdsdeb8
<.  Wympltjctdg ubacr strcss
;.  _lrlsympltjctdg rcturb te be-
rml` er rc`lxca meac

_L[QW EF L BCS[EB

  Acbardtcs
- [cgcdvc stdmu`us lba glrrdcs dmpu`scs

tewlra tjc gc`` keay

  Gc`` Keay
- Gebtldbs bug`cus & mest ef gytep`lsm

- _crferms mest ef tjc mctlke`dg lgtdvdty

ef tjc gc``, dbg`uadbn tjc ncbcrltdeb ef
@CWWEB ;8 BCS[EBW 
LQ_ lba sybtjcsds ef pretcdb

BCS[EB   Lxeb
-  Klsdg fubgtdebl` gc`` ef bcrveus systcm
- Fdkcr wjdgj glrrdcs dmpu`scs lwly frem
-  Mcsslncs tlic tjc ferm ef c`cgtrdgl`
tjc gc`` keay
sdnbl`s,, lba lrc ibewb ls DM_S@WCW.
sdnbl`s DM_S@WCW.
-  L Bcureb glrrdcs dmpu`scs db eb`y EBC - Cbas db l scrdcs ef sml`` swc``dbns gl``ca
adrcgtdeb. 
adrcgtdeb.  tcrmdbl`s  
lxeb tcrmdbl`s
-  Qrlbsmdts dmpu`scs (up te ;3? mpj)
mpj)
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

Cxgdtltery8 acpe`lrdzc
pestsyblptdg gc``
Dbjdkdtery8 jypcrpe`lrdzc
pestsyblptdg gc``
  [e`c ef pestsyblptdg bcureb8 dbtcnrltc
lba pregcss dbfermltdeb

@CWWEB 78 ADWE[AC[W EF QJC BC[VESW

WTWQCM
MCME[T

  Lssegdltdeb ds tjc `dbilnc ef dbfermltdeb

te strugturl` lba gjcmdgl` gjlbncs
   Wgjwlbb Gc``s 
- Gc``s wjdgj preaugc myc`db er flt `lycrr Wjert Qcrm - fcw kdts `lsts l geup`c ef jeurs
db tjc _crdpjcrl` Bcrveus Wystcm @ebn Qcrm - pcrmlbcbt lba `dmdt`css

   Myc`db sjcltj 
 ‗  Acbsc `dpda `lycr wjdgj dbsu`ltcs tjc ADWE[AC[W EF QJC BC[VESW WTWQCM
lxeb
 ‗ Mlics tjc lxeb `eei nrly Q[LSMLQDG K[LDB DBHS[T
-  L bebacncbcrltdvc, bebgebncbdtl`
   Beac ef [lbvdcr almlnc te tjc krldb frem lb cxtcrbl`
 ‗ Nlps er beacs db tjc myc`db sjcltj mcgjlbdgl` fergc.
-  GLSWCW 
Dmpu`scs trlvc` frem acbardtc te gc`` keay te Fl``s (;:%)
lxeb Meter vcjdg`c-trlffdg grlsjcs (;?%)
Wtrugi ky/lnldbst (<4%)
Lsslu`ts (<<%)

G@EWCA K[LDB DBHS[T

<. Gebgussdeb

 
- Mest gemmeb typc ef QKD
-  Almlnc te bcrvcs er k`eea vcssc`s db
tjc krldb eftcb glusca ky lb dmplgt te
tjc jcla

QT_CW EF GJCMDGL@ WTBL_WC ;. Gcrckrl` Gebtusdebs

   Lgcty`gje`dbc8 bcuremusgu`lr hubgtdebs, -  Ds l krudsc er k`ccadbn eb tjc krldb tjlt

n`lbas, krldb lba spdbl` gera glb kc glusca ky lb dmplgt

   Bercpdbcpjcrdbc8 lffcgts krldb rcndebs 7. Adffusc Lxebl` Dbhury

gebgcrbca wdtj cmetdebs, arclmdbn
-  Qclrdbn ef bcrvc
bcrvc tdssuc er k`eea vcssc`s
Q[LBWFC[ EF DBFE[MLQDEB F[EM BCS[EB wjcb tjc krldb ds hest`ca db tjc siu``, glb
QE QL[NCQ  rcsu`t frem sjlidbn er wjdp`lsj

Wyblptdg trlbsmdss
trlbsmdssdeb8
deb8 1. Geup-gebtrcgeup Dbhury

   [c`clsc ef bcuretrlbsmdttcr8 nrlaca -  Dmplgt bet eb`y dbhurcs tjc sdtc ef dmplgt,
petcbtdl` lgjdcvca kut gluscs tjc krldb te dmplgt wdtj tjc
   Cffcgts ef bcuretrlbsmdttcr8
bcuretrlbsmdttcr8 siu``
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

E_CB K[LDB DBHS[T - Qjc besc, idabcys, lba ml`c

rcpreaugtdvc ernlbs mly l`se kc
   Ekhcgt  pcbctrltcss krldb tdssuc,
Ekhcgt pcbctrltc tdssuc, sugj ls l
lffcgtca
ku``ct er sjlttcrca pdcgc ef siu``

7. _e`de
DBFCGQDEBW
tjc  pe`devdrus.
Dt ds glusca ky tjc  pe`devdrus. Dt sprclas frem
<. Mcbdbndtds
pcrseb te pcrseb lba glb dbvlac lb dbfcgtca
(JLCME_JD@SW DBF@SCBXLC MCBDBNDQDW) pcrseb—s krldb lba spdbl` gera, glusdbn plrl`ysds.

   Glusca ky Jlcmep
Jlcmepjd`us
jd`us dbf`ucbzlc Wukg`dbdgl` Dbfcgtdeb
Qypc k klgtcrdl    Be symptems, er symptems `lstdbn >;
   Ssul``y sprclas frem semcwjcrc db tjc jeurs er `css9 mly ne ubbetdgca.
rcspdrltery trlgt te tjc k`eeastrclm lba    Wymptems8
tjcb te tjc mcbdbncs   W`dnjt fcvcr

(MCBDBNEGEG
(MCBDBNEGEGGL@
GL@ MCBDBNDQDW)   jclalgjc

  ncbcrl` adsgemfert er ubclsdbcss

   Dbfcgtdeb glusca ky tjc klgtcrdum   Werc tjrelt
mcbdbndtdads 
Bcdsscrdl mcbdbndtdads    rca tjrelt
   Glusc dbfcgtdeb 
dbfcgtdeb  db l plrt ef tjc keay   vemdtdbn
tjcb, fer ubibewb rclsebs, tjc klgtcrdl
Bebplrl`ytdg 
Bebplrl`ytdg 
mly tjcb sprcla tjreunj tjc
k`eeastrclm te tjc bcrveus systcm    acvc`ep symptems tjlt aecsb't `cla te
(_BCSMEGEGGL@
(_BCSMEGEGGL@ MCBDBNDQDW) plrl`ysds (lkertdvc pe`de), wjdgj glb `lst
up te <? alys
   Glusca ky l klgtcrdl gl``ca    gluscs tjc slmc md`a, f`u-`dic sdnbs lba
pbcumebdl 
strcptegeggus pbcumebdl  symptems typdgl` ef etjcr vdrl` d``bcsscs
   Glb kc glrrdca jlrm`css`y db tjc klgi ef
tjc tjrelt ky ketj lau`ts lba gjd`arcb _lrl`ytdg
   K`eea vcssc`s db tjc `dbdbn ef tjc krldb    Wlmc symptems ls bebplrl`ytdg pe`de
lrc almlnca wdtjdb l wcci, kut mly dbg`uac8
   Mcbdbncs kcgemc dbf`lmca  lba
 lba prcssurc
   @ess ef rcf`cxcs
lreuba tjc krldb glb glusc bcrvc
almlnc    Wcvcrc musg`c lgjcs er wclibcss
   `eesc lba f`eppy `dmks (f`lggda plrl`ysds)
;. @cpresy (Jlbscb—s adsclsc) 
adsclsc) 

Dt ds  lb dbfcgtdeb glusca ky s`ew-nrewdbn

1. Qctlbus
`cprlc.. Dt ds l
klgtcrdl gl``ca Mygeklgtcrdum `cprlc
adsclsc tjlt gluscs scvcrc, adsfdnurdbn sidb sercs    L adsclsc glusca ky tjc texdb ef tjc
lba bcrvc almlnc db tjc lrms, `cns, lba sidb klgtcrdum G`estrdadum tctlbd  tjlt lffcgts
lrcls lreuba tjc keay. tjc gcbtrl` bcrveus systcm, semctdmcs
rcsu`tdbn db acltj.
   Qukcrgu`eda 
   Wpercs ef tjc klgtcrdum preaugc l
- jlvc eb`y ebc er l fcw pltgjcs ef f`lt,
tctlbesplsmdb  
bcuretexdb, gl``ca tctlbesplsmdb
pl`c-ge`erca sidb (plugdklgd``lry `cpresy)
- Lffcgtca lrcl ef sidb mly fcc` bumk
kcglusc ef bcrvc almlnc ubacrbcltj 3. Ketu`dsm
   @cpremlteus     Ketu`dsm ds glusca ky G`estrdadum
- jls wdacsprcla sidb
sidb kumps lba rlsjcs
klgtcrdl  tjlt `dvc db sed` lba aust. Qjcsc
klgtcrdl 
(mu`tdklgd``lry `cpresy), bumkbcss, lba
klgtcrdl mly l`se gebtlmdbltc feeas,
musg`c wclibcss
cspcgdl``y jebcy.

Wgdcbgc [cvdcwcr 7ra \ulrtcr
   G`estrdadum klgtcrdl preaugc l texdb
ketu`dbum texdb,
gl``ca ketu`dbum  texdb, wjdgj k`egis tjc
berml` mcsslncs kctwccb musg`cs lba
bcrvcs   lba lffcgts musg`cs cvcrywjcrc
bcrvcs
db tjc keay.
6. Wjdbn`cs (Jcrpcs Xestcr)

  Lb dbfcgtdeb glusca ky tjc vlrdgc``l-
zestcr vdrus,
vdrus, wjdgj ds tjc slmc vdrus tjlt
gluscs gjdgicbpex
   Acvc`eps wjcb tjc vdrus rclgtdvltcs db
tjc keay.
  Gjlrlgtcrdzca ky l rca sidb rlsj tjlt glb
glusc pldb lba kurbdbn
>. Cbgcpjl`dtds
   Lb lgutc dbf`lmmltdeb (swc``dbn) ef tjc
krldb usul``y rcsu`tdbn frem cdtjcr l
vdrl` dbfcgtdeb er auc te tjc keay's ewb
dmmubc systcm mdstlicb`y lttlgidbn
krldb tdssuc
  Adffcrcbt typcs jlvc adffcrcbt gluscs
  Hlplbcsc cbgcpjl`dtds -
mesqudtecs
  Qdgi-kerbc cbgcpjl`dtds - tdgis
  [lkdcs - mlmml`
   _rdmlry er dbfcgtdeus cbgcpjl`dtds
cbgcpjl`dtds  -
fubnus, vdrus, er klgtcrdum
   Wcgebalry, er pest-dbfcgtdeus
pest-dbfcgtdeus  - dmmubc
mdstlicb`y lttlgis tjc krldb.
:. [lkdcs
   Acla`y vdrus sprcla te pcep`c frem tjc
sl`dvl ef dbfcgtca lbdml`s. Qjc rlkdcs
vdrus ds usul``y trlbsmdttca tjreunj l
kdtc
   _rc`dmdblry symptems lrc md`a lba
vlrdca, mly rcscmk`c mlby etjcr
dbfcgtdebs
   ^jcb GBW kcgemcs dbve`vca pcrseb
l`tcrbltcs kctwccb lndtltdeb lba gl`m
   Musg`c splsms ef meutj lba pjlrybx
FSBGQDEBL@ ADWE[AC[W
<. Jclalgjc - Glb kc l sdnb ef strcss er
cmetdebl` adstrcss, er dt glb rcsu`t frem l
mcadgl` adseracr, sugj ls mdnrldbc er jdnj
k`eea prcssurc, lbxdcty, er acprcssdeb  bcrvc.
   _[DML[T - glusca ky evcrlgtdvdty ef
er prek`cms wdtj pldb-scbsdtdvc
strugturcs db yeur jcla
l.  Qcbsdeb Jclalgjcs
- glusc md`a te meacrltc
pldb lba gemc lba ne evcr
tdmc.
- Ssul``y jlvc be etjcr
symptems.
k.  Mdnrldbc Jclalgjcs
- Eftcb acsgrdkca ls
peubadbn, tjrekkdbn pldb
- glb `lst frem 1 jeurs te 7
alys lba usul``y jlppcb ebc
te feur tdmcs l mebtj
g.  G`ustcr Jclalgjcs
- Gyg`dgl` plttcrbs er g`ustcr
pcrdeas
- Gemmeb`y lwlicbs yeu db
tjc mdaa`c ef tjc bdnjt wdtj
dbtcbsc pldb db er lreuba ebc
cyc eb ebc sdac ef yeur jcla.
jcla.
   WCGEBAL[T - glusca ky evcrlgtdvdty
ef er prek`cms wdtj pldb-scbsdtdvc
strugturcs db yeur jcla. 
;. Cpd`cpsy
  L gebadtdeb gjlrlgtcrdzca ky rcgurrcbt
scdzurcs (twe er merc) rcsu`t frem lb
lkberml` lba cxgcssdvc bcurebl`
adsgjlrnc
  Wdnb ef gcrckrl` aysfubgtdeb
l.  @egl`dzca
@egl`dzca  - glusca ky `egl`dzca lrcl
ef krldb aysfubgtdeb (tjc
cpd`cptdg fegus db gcrckrl`
gertcx lba ae bet sprcla)
lba symptems lrc rc`ltca te
lrcl dbve`vca
k.  Ncbcrl`dzca 
Ncbcrl`dzca  - tjc lkberml`
dmpu`scs erdndbltc frem tjc
gcrckrl` gertcx
gertcx lba sprcla
sprcla
7. Bcuren`dl - L stlkkdbn, kurbdbn, lba eftcb
scvcrc pldb auc te lb drrdtltca er almlnca
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr
WQ[SGQS[L@ ADWE[AC[W
Wpdbl` Gera Dbhury
  Qrlumltdg  - mly stcm frem l suaacb,
trlumltdg k`ew te tjc spdbc tjlt
frlgturcs, ads`egltcs, grusjcs er
gemprcsscs ebc er merc ef tjc
vcrtckrlc

  Beb-Qrlumltdg - mly kc glusca ky
lrtjrdtds, glbgcr, dbf`lmmltdeb er
dbfcgtdebs, er adsi acncbcrltdeb ef tjc
spdbc
Adseracrs8
<. Kc``—s _l`sy 
_l`sy  yeur krldb `clis er rupturcs
-  gluscs suaacb, tcmperlry wclibcss db
tjc flgdl` musg`cs
-  mlics jl`f ef tjc flgc lppclr te areep
Wmd`c ds ebc-sdaca, lba tjc cyc eb tjlt
sdac rcsdsts g`esdbn
;. Glrpl` Qubbc` Wybaremc
-  eggurs wjcb tjc tubbc` kcgemcs
blrrewca er wjcb tdssucs surreubadbn
tjc f`cxer tcbaebs swc``, puttdbn
prcssurc eb tjc mcadlb bcrvc
7. Wpebay`esds
-  rcfcrs te acncbcrltdvc gjlbncs db tjc
spdbc sugj ls kebc spurs lba
acncbcrltdbn dbtcrvcrtckrl` adsgs
kctwccb tjc vcrtckrlc
1. Krldb er Wpdbl` Gera Qumers
-  Mlsscs ef lkberml` gc``s db tjc krldb er
spdbl` gera tjlt jlvc nrewb eut ef
gebtre`
-  kcbdnb 
kcbdnb  (beb-glbgcreus)
(beb-glbgcreus)   tumers lba
ml`dnblbt tumers (glbgcreus
(glbgcreus))
3. _crdpjcrl` Bcurepltjy
-  l rcsu`t ef almlnc te tjc pcrdpjcrl`
bcrvcs, eftcb gluscs wclibcss,
bumkbcss lba pldb, usul``y db yeur
jlbas lba fcct
6. Nud``ldb-Klrrä Wybaremc
-  l rcsu`t ef almlnc te tjc pcrdpjcrl`
bcrvcs, eftcb gluscs wclibcss,
bumkbcss lba pldb, usul``y db yeur
jlbas lba fcct
VLWGS@L[ ADWE[AC[W
<. Wtreic - eggurs wjcb tjc k`eea supp`y te plrt
ef yeur krldb ds dbtcrruptca er rcaugca,
acprdvdbn krldb tdssuc ef exyncb lba butrdcbts
l)  Dsgjcmdg streic
   eggur wjcb tjc lrtcrdcs te yeur
krldb kcgemc blrrewca er
k`egica, glusdbn scvcrc`y
rcaugca k`eea f`ew (dsgjcmdl)
  Qjremketdg streic
  Cmke`dg streic
k)  Jcmerrjlndg streic 
   eggurs wjcb l k`eea vcssc` db
  Dbtrlgcrckrl` jcmerrjlnc.
  Wuklrlgjbeda jcmerrjlnc
g)  Qrlbsdcbt dsgjcmdg lttlgi (QDL) 
   Wemctdmcs ibewb ls l
mdbdstreic . Dt ds l tcmperlry
mdbdstreic.
pcrdea ef symptems sdmd`lr te
tjesc yeu'a jlvc db l streic
;. Lbcurysm
-  L ku`nc er kl``eebdbn db l k`eea vcssc` db
tjc krldb.
-  Glb `cli er rupturc, glusdbn k`ccadbn
dbte tjc krldb (jcmerrjlndg streic).
ACNCBC[LQDEB
<. _lridbseb—s Adsclsc 
Adsclsc 
-  Gcrtldb bcrvc gc``s (bcurebs) db tjc krldb
nrlaul``y krcli aewb er adc.
-  Wymptems lrc auc te l `ess ef bcurebs
tjlt preaugc l gjcmdgl` mcsscbncr db
yeur krldb gl``ca aeplmdbc.
;. Mu`tdp`cs Wg`cresds
-  Dmmubc systcm ml`fubgtdeb acstreys
tjc fltty sukstlbgc tjlt gelts lba
pretcgts bcrvc fdkcrs db tjc krldb lba
spdbl` gera (myc`db).
7. Lmyetrepjdg @ltcrl` Wg`cresds (L@W) er @eu
Ncjrdn's adsclsc
-  _renrcssdvc bcrveus systcm adsclsc tjlt
lffcgts bcrvc gc``s db tjc krldb lba spdbl`
gera, glusdbn `ess ef musg`c gebtre` .
1. Jubtdbnteb Gjercl
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

-  lb dbjcrdtca adsclsc tjlt gluscs tjc QJC GJCMDWQ[T EF JEMEBCW

prenrcssdvc krcliaewb (acncbcrltdeb)
  Lmdbe lgda-klsca jermebcs
ef bcrvc gc``s db tjc krldb
l.  _retcdbs
3. Acmcbtdl
k.  _cptdacs
-  Evcrl`` tcrm fer adsclscs lba gebadtdebs
gjlrlgtcrdzca ky l acg`dbc db mcmery, g.   Lmdbcs
`lbnulnc, prek`cm-se`vdbn lba etjcr
 
tjdbidbn sid``s 
sid``s  tjlt lffcgt l pcrseb's Wtcredas ‗ mlac frem gje`cstcre`
lkd`dty te pcrferm cvcryaly lgtdvdtdcs.   _restln`lbadbs
_restln`lbadbs  ‗
 ‗ mlac frem jdnj`y lgtdvc
`dpdas
_WTGJELGQDVC A[SNW MCGJLBDWM EF JE[MEBC LGQDEB

•  LGQDEB8 lffcgts jdnjcr krldb fubgtdebs   Jermebcs lffcgt eb`y gcrtldb tdssucs er
•  _WTGJE@ENDGL@ AC_CBACBGC8 uscr ernlbs (tlrnct
(tlrnct gc``s er ernlbs)
ernlbs)
grlvcs tjc fcc`dbn lssegdltca wdtj tjc   Qlrnct gc``s must jlvc spcgdfdg pretcdb
arun rcgcpters
•  QE@C[LBGC8 tlics merc ef tjc   Jermebc kdbadbn dbf`ucbgcs tjc weridbn
sukstlbgc te lgjdcvc tjc slmc lffcgt ef tjc gc``s
•  LAADGQDEB8 tjc bcca te gebtdbuc
ektldbdbn lba usdbn l sukstlbgc9 be frcc CFFCGQW GLSWCA KT JE[MEBCW
gjedgc   Gjlbncs db p`lsml mcmkrlbc
pcrmclkd`dty er c`cgtrdgl` stltc
•  ^DQJA[L^L@8 pjysdgl` symptems tjlt
eggur upeb steppdbn tjc arun   Wybtjcsds ef pretcdbs, sugj ls cbzymcs

  Lgtdvltdeb er dblgtdvltdeb ef cbzymcs

c bzymcs

@CWWEB 18 QJC CBAEG[DBC WTWQCM   Wtdmu`ltdeb ef mdtesds

CBAEG[DBC WTWQCM GEBQ[E@ EF JE[MEBC [C@CLWC

-  Wcgeba mcsscbncr systcm ef tjc keay   L stdmu`us er `ew jermebc `cvc`s db tjc
-  Sscs gjcmdgl` mcsslncs (jermebcs)
(jermebcs)   k`eea trdnncrs tjc rc`clsc ef merc
tjlt lrc rc`clsca dbte tjc k`eea jermebc

  Jermebc rc`clsc steps ebgc lb

JE[MEBCW lppreprdltc `cvc` db tjc k`eea ds rclgjca

-  Jermebcs gebtre` scvcrl` mlher   Jermebc `cvc`s db tjc k`eea lrc

pregcsscs mldbtldbca ky bcnltdvc fccaklgi
  [cpreaugtdeb
JE[MEBL@ WQDMS@D EF CBAEG[DBC
  Nrewtj lba acvc`epmcbt
N@LBAW
  Mekd`dzltdeb ef keay acfcbscs

  Mldbtcblbgc ef mugj ef jem-   Cbaegrdbc n`lbas lrc lgtdvltca ky etjcr

cestlsds jermebcs
  [cnu`ltdeb ef mctlke`dsm

-  _reaugca ky spcgdl`dzca gc``s

-  Wcgrctca ky gc``s dbte cxtrlgc``u`lr f`udas
-  Qrlbsfcrrca ky k`eea te tjc tlrnct sdtcs
-  [cnu`ltc tjc lgtdvdty ef etjcr gc``s

Wgdcbgc [cvdcwcr 7ra \ulrtcr
   Gjlbndbn k`eea `cvc`s ef gcrtldb debs
stdmu`ltc jermebc rc`clsc
BCS[L@ WQDMS@D EF CBAEG[DBC N@LBAW
   Bcrvc dmpu`scs stdmu`ltc jermebc
rc`clsc
   Mest lrc ubacr gebtre` ef
sympltjctdg bcrveus systcm
MLHE[ _L[QW EF QJC CBAEG[DBC WTWQCM
<. _dbcl` N`lba
-  Feuba eb tjc tjdra vcbtrdg`c ef tjc krldb
-  mc`ltebdb  (jc`ps cstlk`dsj tjc
Wcgrctcs mc`ltebdb
keay—s wlic lba s`ccp gyg`cs)  vlsegebstrdgtdeb `cladbn te
;. _dtudtlry N`lba
-  Wdzc ef l nrlpc
-  Jlbns ky l stl`i frem tjc jypetjl`lmus
Lbtcrder pdtudtlry (n`lbau`lr tdssuc) 

  Nrewtj Jermebc
  Ncbcrl` mctlke`dg jermebc
  sic`ctl` musg`cs lba `ebn kebcs
  Lmdbe lgdas dbte pretcdb
  Flt kreicb aewb fer cbcrny
  _re`lgtdb (_[@) 
  Wtdmu`ltcs lba mldbtldbs md`i
preaugtdeb fe``ewdbn gjd`akdrtj
  Fubgtdeb db ml`cs ds ubibewb
  Qjyreda-stdmu`ltdbn
Qjyreda-stdmu`ltdbn jermebc (QWJ) 
  Dbf`ucbgcs nrewtj lba lgtdvdty ef
tjc tjyreda
tjc
  Larcbegertdgetrepdg jermebc (LGQJ) 
Larcbegertdgetrepdg
  [cnu`ltcs cbaegrdbc lgtdvdty ef
tjc larcbl` gertcx
  Neblaetrepdg Jermebcs  ‗
 ‗   rcnu`ltcs
jermebl` lgtdvdty ef tjc neblas
  Fe``dg`c-Wtdmu`ltdbn Jermebc
(FWJ) - Wtdmu`ltcs fe``dg`c (ev-
lrdcs) lba spcrm (tcstcs) acvc-
`epmcbt 
  @utcdbdzdbn Jermebc (@J)
- Qrdnncrs evu`ltdeb
- [upturca fe``dg`c kcgemc gerpus
`utcum
- Wtdmu`ltcs tcstestcrebc preau-
gtdeb
_estcrder pdtudtlry (bcrveus tdssuc) 
  Exytegdb
  Wtdmu`ltcs gebtrlgtdebs ef tjc
utcrus aurdbn `lker
  Md`i chcgtdeb
  Lbtdadurctdg Jermebc (LAJ)
  Dbjdkdt urdbc preaugtdeb
  @lrnc lmeubts glusc
dbgrclsca K_ (vlseprcssdb) 
(vlseprcssdb)  
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

‐_dtudtlry - Jypetjl`lm
Jypetjl`lmus
us [c`ltdebsjdp”
[c`ltdebsjdp” 

•  [c`clsc ef jermebcs ds gebtre``ca ky

rc`clsdbn lba dbjdkdtdbn jermebcs
preaugca ky tjc jypetjl`lmus
•  Jypetjl`lmus preaugcs twe jermebcs
tjlt lrc trlbspertca te tjc pestcrder
pdtudtlry
•  Qjc pestcrder pdtudtlry ds BEQ WQ[DGQ@T 
lb cbaegrdbc n`lba, kut aecs rc`clsc 3. Larcbl` N`lbas
-  Wdts eb tep ef tjc idabcys
jermebcs
-  Qwe n`lbas

7. Qjyreda N`lba Larcbl` Gertcx (eutcr n`lbau`lr rcndeb db

tjrcc `lycrs)
-  Feuba lt tjc klsc ef tjc tjrelt   Mdbcrl`egertdgedas (
 (mldb`y
mldb`y l`aestcrebc) 
l`aestcrebc) 
-  Gebsdsts ef twe `ekcs lba l gebbcgtdbn   [cnu`ltc mdbcrl` gebtcbt db

dstjmus k`eea, wltcr, lba c`cgtre`ytc

kl`lbgc
   Qjyreda Jermebc   Qlrnct ernlb8 idabcy

  Mlher mctlke`dg jermebc   [cnu`ltc tjc gebgcbtrltdeb ef

  Gempesca ef twe lgtdvc deadbc-

petlssdum lba seadum db tjc
keay
gebtldbdbn jermebcs

l.  Qjyrexdb (Q1) ‗ scgrctca ky   N`ugegertdgedas ( ddbg`uadbn
bg`uadbn gertdsebc lba
gertdse`)
tjyreda fe``dg`cs
  _remetc berml` gc`` mctlke`dsm
k.  Qrddeaetjyrebdbc (Q7) ‗ 
  Jc`p rcsdst `ebn-tcrm strcssers
gebvcrsdeb ef Q1 lt tlrnct
  [c`clsca db rcspebsc te dbgrclsca
tdssucs k`eea `cvc`s ef LGQJ
   Gl`gdtebdb   Wcx jermebcs8 Lbarenc
jermebcs8 Lbarencbsbs lba
  Acgrclscs k`eea gl`gdum `cvc`s ky semc Cstrencb
acpesdtdeb ef kebc
   Lbtlnebdstdg te plrltjyreda
jermebc Larcbl` Mcau``l (dbbcr bcurl` tdssuc
rcndeb)
  Cpdbcpjrdbc (Larcbl`dbc)
(Larcbl`dbc)  
  Dbgrclsc glradlg eutput

  [ldsc n`ugesc `cvc`s db tjc k`eea 

  Bercpdbcpjrdbc (Berlarcbl`dbc)

  Dbgrclscs jclrt rltc lba K_

  Qrdnncrs rc`clsc ef n`ugesc

  Dbgrclscs k`eea f`ew te sic`ctl`

musg`c
  [caugcs k`eea f`ew te tjc
1. _lrltjyreda N`lba nlstredbtcstdbl` systcm
  Dbjdkdts vedadbn ef tjc k`laacr
-  Qdby mlsscs eb tjc pestcrder ef tjc
lba nlstredbtcstdbl` metd`dty
tjyreda
6. _lbgrcls (Ds`cts ef @lbncrjlbs)
   _lrltjyreda Jermebc (_lrltjermebc
(_lrltjermebc)) -  Qjc plbgrcls ds l mdxca n`lba
  Wtdmu`ltc estceg`lsts te rcmevc
-  Qjc ds`cts ef tjc plbgrcls preaugc
gl`gdum frem kebc jermebcs8
  Wtdmu`ltc tjc idabcys lba dbtcstdbc
d btcstdbc
te lkserk merc gl`gdum
  [ldsc gl`gdum `cvc`s db tjc k`eea
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

   Dbsu`db @CWWEB 38 ADWE[AC[W EF QJC

  L``ews n`ugesc te gress p`lsml
CBAEG[DBC WTWQCM
mcmkrlbcs dbte gc``s frem kctl
gc``s @CWWEB 68 ML@C [C_[EASGQDVC
  N`uglneb
WTWQCM
  L``ews n`ugesc te cbtcr tjc

k`eea frem l`pjl gc``s -  Ml`c lba fcml`c rcpreaugtdvc systcms

acvc`ep frem sdmd`lr cmkryebdg tdssuc.

>. Qjymus -  Aurdbn fctl` acvc`epmcbt tjcy lrc bclr

-  @egltca pestcrder te tjc stcrbum tjc idabcys lba
idabcys lba s`ew`y mevc dbfcrder`y db
-  @lrncst db dbflbts lba gjd`arcb tjc lkaemdbl` glvdty.
-  Aurdbn tjc > tj mebtj
 mebtj tjcy
 tjcy acsgcba
   Qjymesdb
tjreunj tjc dbnudbl` glbl`s
  Mlturcs semc typcs ef wjdtc

k`eea gc``s
  Dmpertlbt db acvc`epdbn tjc _L[QW EF QJC ML@C [C_[EASGQDVC WTWQCM
dmmubc systcm
<. Wgretum

  Wlg ef sidb lba supcrfdgdl` flsgdl tjlt

:. Evlrdcs
jlbns eutsdac tjc lkaemdbepc`vdg glvdty
  Cstrencbs
lt tjc reet ef tjc pcbds
  Wtdmu`ltcs tjc acvc`epmcbt ef
  Dts cxtcrbl` pesdtdebdbn iccps tjc tcstcs
scgebalry fcml`c gjlrlgtcrdstdgs 
gjlrlgtcrdstdgs 
  Mlturcs fcml`c rcpreaugtdvc ernlbs
7G `ewcr tjlb gerc keay tcmpcrlturc
  Jc`ps prcplrc tjc utcrus te rcgcdvc l

fcrtd`dzca cnn
  _reaugca ky tjc p`lgcbtl

  Jc`ps mldbtldb prcnblbgy


  _rcplrcs krclsts te preaugc md`i
   _rencstcrebc
  Lgts wdtj cstrencb te krdbn lkeut

mcbstrul` gyg`c _L[QW EF QJC WG[EQSM

  Jc`ps db tjc dmp`lbtltdeb ef lb
l.  Alrtes Musg`c 
cmkrye db tjc utcrus
4. Qcstcs -  l tjdb `lycr ef smeetj musg`c
  Lbarencbs
db tjc acrmds
  Grugdl` fer ml`c scxul` lba -  gebtrlgtdebs ef tjds musg`c
rcpreaugtdvc fubgtdeb gluscs wrdbi`dbn ef tjc sidb
  Qcstestcrebc (mest dmpertlbt k.  Qubdgl Vlndbl`ds
lbarencb) -  cbg`escs clgj tcstcs
  Ml`c scgebalry gjlrlgtcrdstdgs -  l gebtdbultdeb ef tjc
  Nrewtj lba mlturltdeb ef ml`c pcrdtebcum tjlt `dbcs tjc
rcpreaugtdvc systcm lkaemdbepc`vdg glvdty
  [cqudrca fer spcrm gc`` rcpreaugtdeb g.  Qubdgl L`kundbcl
-  L fdkreus glpsu`c gevcrs clgj
tcstds
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

ASGQ WTWQCM EF QJC ML@C [.W

;. Qcstdg`c (Qcstcs)
-  Wpcrm gc``s plss tjreunj l scrdcs ef augts
   Lb evl` strugturc lkeut 3 gm `ebn lba 7 te rclgj tjc eutsdac ef tjc keay. Lftcr tjcy
gm db adlmctcr `clvc tjc tcstcs, tjc spcrm plsscs tjreunj
   Qjc tubdgl l`kundbcl ndvcs rdsc te scptl tjc cpdadaymds, augtus acfcrcbs,
(plrtdtdebs)  tjlt advdac tjc tcstds dbte
(plrtdtdebs)  chlgu`ltery augt, lba urctjrl.
`eku`cs (lkeut ;3?)
   Clgj `eku`c gebtldbs 7 er 1 jdnj`y ged`ca
scmdbdfcreus tuku`cs 
   Qjcsc gebvcrnc te kcgemc rctc tcstds 
wjdgj trlbspert spcrm te tjc
cpdadaymds 
   Dbtcrstdtdl` gc``s (gc``s ef @cyadn) ‗
@cyadn) ‗  pre-
augc ml`c scx jermebcs, lrc `egltca
kctwccb tjc scmdbdfcreus tuku`cs
wdtjdb l `eku`c. 
`eku`c.  _L[QW EF QJC ASGQ WTWQCM
7. Cpdadaymds 3. Augtus Acfcrcbs (Vls Acfcrcbs)
   L `ebn tukc (lkeut 6 mctcrs) `egltca   L fdkremusgu`lr tukc tjlt ds gebtdbueus
l`ebn tjc supcrder lba pestcrder wdtj tjc cpdadaymds
mlrndbs ef tjc tcstcs
   Gemp`ctc spcrm mlturltdeb pregcss 6. Chlgu`ltery Augt
lba kcgemc fcrtd`c ls tjcy mevc   plsscs tjreunj tjc prestltc n`lba lba
tjreunj tjc cpdadaymds. cmptdcs dbte tjc urctjrl
   Mlturc spcrm lrc sterca  db
 db tjc `ewcr
pertdeb, er tld`, ef tjc cpdadaymds >. Srctjrl

  Cxtcbas frem tjc urdblry k`laacr te tjc

cxtcrbl` urctjrl` erdfdgc lt tjc tdp ef tjc
pcbds.
  L plsslncw
 plsslncwly
ly fer spcrm lba f`udas 
f`udas frem
tjc rcpreaugtdvc systcm lba urdbc frem
tjc urdblry systcm

1. Wpcrmltdg Gera
LGGCWWE[T N@LBAW EF QJC ML@C [.W
   Gebtldbs tjc strugturcs rubbdbn frem tjc
:. Wcmdbl` Vcsdg`c
tcstdg`cs te tjc pc`vdg glvdty
   Gebtcbts8   @dc eb tjc pestcrder wl`` ef tjc k`laacr
l.  Vls Acfcrcbs lba scgrctc 6?% ef tjc ve`umc ef scmcb
k.  Bcrvcs   Wcmdbl` F`udas8
g.  K`eea Vcssc`s l.  Frugtesc8 prevdacs cbcrny fer tjc
spcrm.
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

k.  Fdkrdbencb8 jc`ps turb scmcb dbte
l ke`us tjlt glb kc rclad`y
prepc``ca dbte tjc vlndbl.
g.  _restln`lbadbs8 acgrclsc gcrvdgl`
mugus vdsgesdty lba stdmu`ltc
rcvcrsc pcrdstl`sds ef tjc utcrus.
4. _restltc N`lba

  Aeunjbut-sjlpca n`lba tjlt cbgdrg`cs
plrt ef tjc urctjrl dbfcrder te tjc
k`laacr
  _`lys l re`c db tjc lgtdvltdeb ef spcrm
  Cbtcrs tjc prestltdg urctjrl aurdbn
chlgu`ltdeb
   _restltdg Wcgrctdebs8
l.  Gdtrltc8 ds l feea seurgc (QGL
gyg`c)
k.  _retce`ytdg cbzymcs8 lgts te
"acgelnu`ltc" tjc scmcb tjlt
wls gelnu`ltca ky scmdbl`
vcsdg`c scgrctdebs, wjdgj jc`ps
tjc spcrm kcndb tjcdr heurbcy
ebgc dbsdac tjc vlndbl
<?. Ku`keurctjrl` N`lbas (Gewpcr—s N`lbas) 
  _cl-sdzca n`lbas dbfcrder te tjc prestltc
  _reaugc l`il`dbc mugus prder te
chlgu`ltdeb tjlt bcutrl`dzcs trlgcs ef
lgdadg urdbc db tjc urctjrl
<<. _cbds
   Ds l gy`dbardgl` pcbalbt ernlb `egltca
lbtcrder te tjc sgretum lba fubgtdebs te
trlbsfcr spcrm te tjc vlndbl

  Gebsdsts ef tjrcc ge`umbs ef crcgtd`c
tdssuc tjlt lrc wrlppca db gebbcgtdvc
tdssuc lba gevcrca wdtj sidb.
ADWE[AC[W EF QJC ML@C [C_[EASGQDVC WTWQCM
Gryptergjdadsm
-  @dtcrl``y ‐jdaacb tcstdg`c.” L gebadtdeb ef
`lgi ef acsgcbt ef ebc er ketj tcstcs dbte
tjc sgretum. Df bet gerrcgtca, usul``y ky
surncry, kcferc pukcrty, glb `cla te
stcrd`dty lba dbgrclsca rdsi ef tcstdgu`lr
glbgcr.
Crcgtd`c aysfubgtdeb (CA)
-  Wcxul` aysfubgtdeb gjlrlgtcrdzca ky tjc
rcnu`lr lba rcpcltca dblkd`dty ef l
scxul``y mlturc ml`c te ektldb er
mldbtldb lb crcgtdeb. Dt ds l gemmeb
adseracr tjlt lffcgts lkeut 1? pcrgcbt ef
ml`cs, lt `clst egglsdebl``y
Cpdadaymdtds
-  Dbf`lmmltdeb ef tjc cpdadaymds.
Adsgemfert er pldb lba swc``dbn db tjc
sgretum lrc typdgl` symptems ef
cpdadaymdtds, wjdgj ds l rc`ltdvc`y
gemmeb gebadtdeb, cspcgdl``y db yeubn
mcb.
_restltc glbgcr
-  Qjc mest gemmeb typc ef glbgcr db mcb,
lba tjc scgeba `cladbn glusc ef glbgcr
acltj db mcb.
Qcstdgu`lr glbgcr
-  Dt ds tjc mest gemmeb glbgcr db ml`cs
kctwccb tjc lncs ef ;? lba 74 yclrs. L
`ump er swc``dbn db ebc tcstds, f`uda db tjc
sgretum, lba tcstdgu`lr pldb er
tcbacrbcss lrc pessdk`c sdnbs lba
symptems ef tcstdgu`lr glbgcr.

   Qjc twe aersl` ge`umbs lrc tjc gerperl

glvcrbesl.   Qjc sdbn`c, mda`dbc vcbtrl`
glvcrbesl. 
ge`umb surreubas tjc urctjrl lba ds
gl``ca tjc gerpus spebndesum
spebndesum..
   7 plrts8
l.  reet
k.  keay (sjlft)
g.  n`lbs pcbds
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

@CWWEB >8 FCML@C [C_[EASGQDVC   Fcrtd`dzltdeb ef tjc cnn eggurs jcrc

WTWQCM
[C_[EASGQDVC WTWQCM

-  Qe pcrpctultc tjc spcgdcs tjreunj

scxul` er ncrm gc`` fcrtd`dzltdeb lba
rcpreaugtdeb
  Qukc wdacbs te ferm tjc lmpu``l 
  Qjc dstjmus
dstjmus  ds tjc pertdeb tjlt
gebbcgts te utcrus
  Fdmkrdl
Fdmkrdl  lrc tjc fdbncr-`dic
prehcgtdebs lreuba tjc epcbdbn tjlt
trlp tjc cnn ls dt `clvcs tjc evlry
_L[QW EF QJC FCML@C [C_[EASGQDVC   Cba ef tukc ds gl``ca tjc
WTWQCM dbfubadku`um 

<. Stcrus
  Epcbdbn ds gl``ca tjc estdum

   L je``ew, musgu`lr, pclr-sjlpca ernlb

lkeut tjc sdzc ef l wemlb—s g`cbgjca fdst  7. Evlrdcs
   Glb kc advdaca dbte tjc keay (gerpus),
  Lttlgjca te clgj sdac ef tjc utcrus ky l
lba tjc kettem gcrvdx 
gcrvdx 
   Fubaus8  reubaca tep pertdeb, lkevc tjc `dnlmcbt
  Evl`-sjlpca, lkeut tjc sdzc ef l `lrnc
fl``epdlb tukcs
e`dvc
   _revdacs l p`lgc fer tjc pretcgtdeb lba
  Fd``ca wdtj cnn-gebtldbdbn slgs gl``ca
beurdsjmcbt ef tjc fctus aurdbn
 fe``dg`cs 
prcnblbgy
  Clgj cnn ds gl``ca lb 
lb  evum 
   Dt gebtrlgts aurdbn `lker te cxpc` tjc
fctus
   7 `lycrs8
l.  _crdmctrdum
k.  Myemctrdum
g.  Cbaemctrdum

Fubgtdebs8

-  Qjc cbaemctrdum sjcas tjc `dbdbn ef tjc

utcrus cvcry ;< te 1? alys ky
mcbstrultdeb
1. Vlndbl
-  Dt prevdacs l p`lgc fer tjc pretcgtdeb lba
beurdsjmcbt ef tjc fctus aurdbn   Cxtcba frem tjc gcrvdx te tjc eutsdac ef
prcnblbgy tjc keay
-  Dt gebtrlgts aurdbn `lker te cxpc` tjc   7 ½ dbgj `ebn musgu`lr tukc tjlt
fctus cxplbas db `cbntj lba wdatj aurdbn
scxul` lreusl`
  Fcml`c ernlb fer gepu`ltdeb
;. Fl``epdlb Qukc   L plsslncwly fer mcbstrultdeb er tjc

   1-6 dbgjcs `ebn kdrtj ef l fctus


  Cnn ds mevca l`ebn dbsdac tjc tukc ky
musgu`lr gebtrlgtdebs lba tjc wlvdbn 3. Vu`vl - 3 ernlbs mlidbn up tjc cxtcrbl`
lgtdeb ef gd`dl ncbdtl`dl ef tjc fcml`c
   Qlics lb cnn lkeut 7-1 alys te trlvc` tjc
`cbntj ef tjc tukc

Wgdcbgc [cvdcwcr 7ra \ulrtcr
Mebs _ukds
-  Qrdlbnu`lr-sjlpca pla ef fltty
tdssuc evcr tjc pukds kebc,
gevcrca wdtj pukdg jldr
@lkdl Mlherl
-  ; `lrnc fe`as ef ladpesc tdssuc eb
tjc sdac ef tjc vlndbl` epcbdbn
@lkdl Mdberl
-  ; sml``cr fe`as ef ladpesc tdssuc
eb tjc dbsdac ef tjc `lkdl
` lkdl mlherl
Vcstdku`c
-  Lrcl kctwccb `lkdl wdtj epcbdbns
fer tjc vlndbl, urctjrl, lba ;
cxgrctery augts fer Klrtje`db—s
n`lbas (prevdac `ukrdglbt)
G`dterds
-  Wcbsdtdvc fe`a ef tdssuc plrtdl``y
gevcrca ky jeea
   _crdbcum
-  Qjc lrcl `egltca kctwccb tjc
vlndbl` epcbdbn lba tjc lbus
   Cpdsdetemy
-  L surndgl` dbgdsdeb aebc te lveda
ubgebtre``ca tclrdbn ef tjc
 pcrdbcum
6. Krclst
   Lrc tjc mlmmlry n`lbas

  Clgj jls <3-;? n`lbau`lr `ekcs scplrltca
ky gebbcgtdvc tdssuc
ADWE[AC[W EF QJC FCML@C [C_[EASGQDVC
WTWQCM
Mcbstrul` Lkberml`dtdcs
Lkberml`dtdcs
  Lmcberrjcl  ‗
 ‗ lkscbgc ef
mcbstrultdeb
  Aysmcberrjcl ‗
 ‗ pldb lssegdltca
wdtj mcbstrultdeb

  Lkberml` utcrdbc k`ccadbn ‗
 ‗ 
cxgcssdvc lmeubt er aurltdeb ef
mcbstrul` k`ccadbn
Cbaemctrdesds
  Nrewtj ef cbaemctrdl` tdssuc
eutsdac ef tjc utcrus
  Qdssuc rcspebas te jermebl`
gjlbncs ky pre`dfcrltdbn tjcb
krclidbn aewb lba k`ccadbn
Glbgcr
  Krclst Glbgcr  ‗‗ ;ba `cladbn glusc ef
glbgcr acltj db tjc SW 
  Evlrdlb Glbgcr  ‗‗ mest gemmeb
glusc ef nybcge`endgl` acltj
cxg`uadbn krclst glbgcr 
  Gcrvdgl` Glbgcr  ‗‗ stlrts ls gcrvdgl`
aysp`lsdl (gjlbnc db sjlpc, nrewtj, lba
be. ef gc``s)
Wcxul``y Qrlbsmdttca Adsclscs
  ‗ klgtcrdl9
  Gj`lmyadl ‗
lsymptemltdg, `clas te stcrd`dty frem
sglr tdssuc fermltdeb 
  Neberrjcl  ‗‗ klgtcrdl9 adsgjlrnc
gemmeb, k`dbabcss df bcwkerb ds
dbfcgtca aurdbn ac`dvcry 
  Wypjd`ds ‗
 ‗ klgtcrdl9 pldb`css sercs
(gjlbgrc), ;ba stlnc8 l`` ernlbs
dbve`vca, 7ra stlnc8 ernlb
acncbcrltdeb ds lpplrcbt
(bcuresypjd`ds) 
  Ncbdtl` Jcrpcs  ‗‗ vdrus9 dbgurlk`c,
pldbfu` k`dstcrs 
  ‗ vdruscs
  LDAW & Jcpltdtds K ‗
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

Tclst Dbfcgtdeb ;>

  ;: <
;
;6 7

;3 1

   Glbadal l`kdglbs  ds yclst`dic fubnus ;1

M c bs t r ul t d eb
3

;7 6
tjlt nrews eb mugeus mcmkrlbcs ;; >

   Gluscs vu`vevlndbl` glbadadlsds  er ;< :

vlndbdtds  ;? 4

<4 <?

-  dbf`lmmltdeb ef tjc vlndbl

mest fcrtd`c
<: <<

-  scvcrc dtgjdbn lba pldb

<> <;
<6 <7
<3 <1

 
- yc``ew adsgjlrnc wdtj eaer   Dt ds glrcfu``y rcnu`ltca ky scvcrl`
  Merc `dic`y lftcr lbtdkdetdg tjcrlpy fer

semc etjcr adsclsc jermebcs8 @utcdbdzdbn Jermebc (@J),

n Jermebc (FWJ), lba
Fe``dg`c-stdmu`ltdbn
Fe``dg`c-stdmu`ltdb
tjc fcml`c scx jermebcs Cstrencb  lba
_rencstcrebc 
@CWWEB :8 QJC MCBWQ[SL@ GTG@C
  Advdaca dbte tjrcc pjlscs8
QC[MDBE@ENDCW8 l.  Fe``dgu`lr (kcferc tjc cnn ds
rc`clsca)
  Cbaemctrdum -
Cbaemctrdum - @dbdbn ef tjc utcrus
k.  Evu`ltery (cnn ds rc`clsca)
  Eegytc
Eegytc -
 - Acvc`epdbn cnn gc``
g.  @utcl` (lftcr rc`clsc ef tjc cnn)
  Evum - Mlturc cnn
Evum -
  Mcbeplusc - @lst mcbstrultdeb
Mcbeplusc -

FLGQW8 _JLWCW EF QJC MCBWQ[SL@ GTG@C

-  ;? wccis ncstltdeb, ~ 3 md``deb cnns <. Fe``dgu`lr _jlsc

(eegytcs)
  Qjc icy lspcgt ef tjds pjlsc ds tjc
-  Lt kdrtj, ½ te < md``deb
acvc`epmcbt ef fe``dg`cs db tjc evlrdcs.
-  Evlrdlb rcscrvc, jeusca ky  prdmeradl`
  Lt tjc stlrt ef tjc fe``dgu`lr pjlsc, tjc
 fe``dg`cs. 
`dbdbn ef tjc utcrus ds tjdgi wdtj f`udas lba
-  7? te 1? fe``dg`cs acvc`ep kcferc
butrdcbts dbtcbaca
butrdcbts  dbtcbaca te beurdsj lb cmkrye
evu`ltdeb kut usul``y eb`y ebc cnn ds
(fcrtd`dzca cnn).
rc`clsca.
  Df be cmkrye ds prcscbt, cstrencb lba
-  1?? cnns lrc evu`ltca db l wemlb—s
prencstcrebc `cvc`s lrc `ew. Qjds gluscs
rcpreaugtdvc `dfc
tjc utcrus `dbdbn te sjca.
-  Lnc ef 7?, ~ <;% ef cnns tjcy jla lt
kdrtj
Mcbstrultdeb  - Qjds pjlsc kcndbs eb tjc fdrst
aly ef k`ccadbn (glb `lst fer 7->
7 -> alys)

Mcbstrul` Gyg`c   Qjc  pdtudtlry n`lba dbgrclscs dts—

 preaugtdeb ef FWJ FWJ.. Qjds jermebc
   Kcndbs wjcb l ndr` rclgjcs tjc lnc ef
stdmu`ltcs tjc nrewtj ef scvcrl` fe``dg`cs
pukcrty
(clgj gebtldbs lb cnn) te acvc`ep db tjc
   Qjc rcpreaugtdvc gyg`c tjlt preaugcs evlrdcs.
cnns fer fcrtd`dzltdeb
   Aurdbn tjds gyg`c tjc utcrus
cbaemctrdum)) prcplrcs dtsc`f fer
(cbaemctrdum
dmp`lbtltdeb ef l fcrtd`dzca cnn, df tjds
aecs bet eggur tjc utcrus `dbdbn ds sjca
frem tjc keay9 tjds ds ibewb
ls mcbstrultdeb  er l "pcrdea ".

  @lsts kctwccb ;:-73 alys   Qjc `cvc`s ef FWJ jermebc acgrclscs lba
tjc fe``dg`cs kcndb te scgrctc cstrencb
cstrencb..
  Aly < ef tjc gyg`c kcndbs eb ds tjc fdrst
  Qjc fe``dg`c tjlt acvc`eps fdrst
aly ef k`ccadbn 
k`ccadbn  lba tjc gyg`c cbas hust
(tjc aemdblbt fe``dg`c) scgrctcs tjc mest
kcferc tjc bcxt mcbstrul` pcrdea.
lmeubt ef cstrencb.
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

   Qjc fe``dgu`lr pjlsc reunj`y `lsts lkeut   @J lba FWJ `cvc`s fl`` klgi te `ew lba
<7 er <1 alys. Qjc pjlsc cbas wjcb tjc stclay `cvc`s.
`cvc` ef `utcdbdzdbn jermebc (@J) surncs   Cstrencb `cvc`s  fl`` l `dtt`c lftcr tjc
arlmltdgl``y @J/FWJ surnc,
surnc, kut rdsc auc te gebtdbuca
scgrctdeb ef cstrencb lba prencstcrebc
ky tjc gerpus `utcum.
;. Evu`ltery _jlsc   Df tjc cnn ds bet fcrtd`dzca, tjc gerpus
`utcum sjrdbis lba kcndbs te acncbcrltc
  
Kcndbs wdtj tjc `utcdbdzdbn jermebc lftcr <1 alys 
alys  (tjc gerpus `utcum ds
surnc (@J surnc).
surnc). Qjc `cvc` ef FWJ
acsdnbca te adc lftcr <1 alys).
dbgrclscs te l `csscr cxtcbt.
  Df tjc cnn ds fcrtd`dzca tjc gc``s, lreuba tjc
   @J stdmu`ltcs cbzymcs db tjc aemdblbt
acvc`epdbn cmkrye kcndb te preaugc l
fe``dg`c lba l`ebn wdtj tjc dbgrclsca
jermebc gl``ca jumlb gjerdebdg
prcssurc gluscs tjc fe``dg`c te rupturc
neblaetrepdb (jGN). 
lba rc`clsc tjc cnn 
cnn (evu`ltdeb).
  Qjds jermebc rcsgucs tjc gerpus `utcum
   Qjc cnn trlvc`s dbte tjc fl``epdlb tukc,
lba l``ews dt te gebtdbuc scgrctdbn
rclay fer fcrtd`dzltdeb. Qjc cnn glb
 prencstcrebc
 prencstcrebc lba cstrencb
cstrencb,, ubtd` tjc
survdvc fer <; te ;1 jeurs  lftcr
nrewdbn fctus glb preaugc dts— ewb
evu`ltdeb.
jermebcs.
   Qjc @J surnc glb kc usca ls l
  _rcnblbgy tcsts lrc klsca eb actcgtdbn lb
mclsurcmcbt te actcrmdbc wjcb l
dbgrclsc db tjc jumlb gjerdebdg
wemlb ds fcrtd`c.
fcrtd`c. Lreuba <; te ;1 jeurs neblaetrepdb `cvc`.
lftcr tjc cnn ds rc`clsca, tjc @J surnc
glb kc actcgtca ky mclsurdbn tjc `cvc`
ef tjds jermebc db urdbc. @CWWEB 48 W_C[MLQENCBCWDW
   Qjc evu`ltery pjlsc usul``y `lsts <6 te
7; jeurs  lba cbas wjcb tjc cnn ds
rc`clsca.

7. @utcl` _jlsc

  Qjds pjlsc kcndbs lftcr evu`ltdeb.

  Dt `lsts lkeut <1 alys  lba cbas hust

kcferc l mcbstrul` pcrdea, ub`css ef JE[MEBCW

geursc fcrtd`dzltdeb eggurs.
  Qjc cnn trlvc`s l`ebn tjc fl``epdlb tukc
tukc   -  Fe``dg`c-stdmu`ltdbn jermebc (FWJ) 
(FWJ) 
ky wlvc `dic metdebs glusca ky tjc stdmu`ltcs spcrmltencbcsds 
spcrmltencbcsds 
fdbncr-`dic prehcgtdebs db tjc wl``s ef tjc -  Dbtcrstdtdl` Gc`` Wtdmu`ltdbn Jermebc (DGWJ)
fl``epdlb tukc. (lil @J) stdmu`ltcs
@J) stdmu`ltcs tjc preaugtdeb ef
   Qjc rcmldbacr ef tjc rupturca fe``dg`c db tcstestcrebc
tjc evlry g`escs lftcr rc`clsdbn tjc cnn -  Qcstestcrebc stdmu`ltcs
Qcstestcrebc  stdmu`ltcs tjc acvc`epmcbt ef
lba ferms l strugturc gl``ca l gerpus ml`c scgebalry scx gjlrlgtcrdstdgs &
`utcum. spcrmltencbcsds
   Qjc gerpus `utcum scgrctcs `lrnc
qulbtdtdcs ef prencstcrebc lba cstrencb 
cstrencb  
lba prcplrcs tjc utcrus fer fcrtd`dzltdeb.
   _rencstcrebc l`se gluscs dbgrclsc db
keay tcmpcrlturc 
tcmpcrlturc  aurdbn tjc `utcl`
pjlsc lba rcmldb c`cvltca ubtd` l
mcbstrul` pcrdea kcndbs.
 

Wgdcbgc [cvdcwcr 7ra \ulrtcr

_[EGCWW -  Qjc spcrm lrc rc`clsca dbte tjc `umcb

ef tjc scmdbdfcre
scmdbdfcreus
us tuku`c 
tuku`c lba `clvc tjc
-  Wpcrm lrc preaugca wdtjdb tjc
tcstcs. Qjcy tjcb cbtcr tjc cpdadaymds.
scmdbdfcreus tuku`cs

-  Qjc cbtdrc pregcss, kcndbbdbn wdtj l

-  Dbtcrspcrsca wdtjdb tjc tuku`cs lrc
prdmlry spcrmltegytc, tlics lkeut >1
`lrnc gc``s wjdgj lrc tjc sustcbtlgu`lr
alys.. Lftcr chlgu`ltdeb, tjc spcrm glb
alys
gc``s (Wcrte`d's gc``s),
gc``s), wjdgj suppert lba
`dvc fer lkeut 1: jeurs 
jeurs  db tjc fcml`c
beurdsj tjc etjcr gc``s. rcpreaugtdvc trlgt.
-  Clr`y db cmkryebdg acvc`epmcbt,
prdmeradl` ncrm gc``s cbtcr tjc tcstcs
lba adffcrcbtdltc dbte spcrmltenebdl  
@CWWEB <?8 _[CNBLBGT
QC[MDBE@ENDCW
-  gc``s,, clgj
Wpcrmltenebdl lrc adp`eda gc``s
wdtj 16 gjremesemcs (;7 pldrs) 
pldrs) `egltca   Ekstctrdgdlb - aegter wje spcgdl`dzcs db
lreuba tjc pcrdpjcry ef tjc scm- glrc ef l prcnblbt wemcb lba tjc
dbdfcreus tuku`cs. acvc`epdbn fctus
  Nybcge`endst - aegter wje spcgdl`dzcs db
glrc ef tjc fcml`c rcpreaugtdvc systcm
  Srdbc tcsts - lkeut ; wccis lftcr
evu`ltdeb.
  K`eea tcsts - lkeut 6 te : alys lftcr yeu
evu`ltc

K`eea tcsts glb pdgi up jGN clr`dcr db l

-  Lt pukcrty, jermebcs stdmu`ltc tjcsc  prcnblbgy tjlb
tjlb urdbc tcsts glb
gc``s te kcndb advdadbn ky mdtesds. Wemc
rcmldb lt tjc pcrdpjcry ls spcrml- _rcnblbgy `lsts lb lvcrlnc ef ;66 alys
tenebdl. (7: wccis) 9
 9 lpprexdmltc`y
lpprexdmltc`y
4 mebtjs ‗  advdaca
  advdaca dbte
-  Etjcrs kcgemc prdmlry spcrml- 7 trdmcstcrs. 
tegytcs. Kcglusc tjcy lrc preaugca ky
mdtesds, prdmlry spcrmltegytcs lrc Wdnbs ef _rcnblbgy
gjremesemcs  
adp`eda lba jlvc 16 gjremesemcs
  Mdssca mcbstrul` pcrdea
-  Clgj prdmlry spcrmltegytcs necs   Cxgcssdvc tcbacrbcss db jcr krclsts
tjreunj tjc fdrst mcdetdg advdsdeb,
mcdesds D,
D, te preaugc twe scgebalry   Fltdnuc

spcrmltegytcs, clgj wdtj ;7   Gjlbnc db lppctdtc

gjremesemcs (jlp`eda)
  Merbdbn Wdgibcss

-  Aurdbn mcdesds D, ebc gjremesemc,

necs te clgj scgebalry spcrmltegytc.
Db tjc scgeba mcdetdg advdsdeb, mcdesds FC[QD@DXLQDEB 
FC[QD@DXLQDEB 
DD, clgj
DD,  clgj scgebalry spcrmltegytc advdacs   Evum glb kc fcrtd`dzca fer fdrst ;1
te preaugc twe spcrmltdas
spcrmltdas.. 
jeurs aurdbn dts 7-> aly heurbcy
tjreunj tjc Fl``epdlb tukc te tjc
-  Qjc fdbl` stcp db tjc acvc`epmcbt tjc utcrus.
spcrmltdas fermca frem
  Mest spcrm `dvc eb`y 7 alys
alys  dbsdac tjc
spcrmltencbcsds kcgemc mlturc 
wemlb—s rcpreaugtdvc trlgt9 semc fer
spcrmltezel, er spcrm. 
3 alys.

Wgdcbgc [cvdcwcr 7ra \ulrtcr
   Qjc cnn pu``s ebc spcrm te dts surflgc,
tjc ‐zebl pc``ugdal” wjcrc spcrm tjcb
scgrctcs lb cbzymc l``ewdbn dt te
pcbctrltc lba cbtcr.
   ^dtjdb ;1-7? jeurs, bug`cd ef spcrm
lba cnn fusc te ferm tjc ebc-gc``ca
‐zynetc  prencstcrebc cbgeurlncs krclst tdssuc
   Gc`` advdsdeb kcndbs
l.  Meru`l stlnc (sml`` ge``cgtdeb
ef gc``s)
k.  K`lstegyst stlnc (evcr <?? gc``s9
f`uda gcbtcr
GEBGC_QDEB LBA DM_@LBQLQDEB
   K`lstegyst lrrdvcs db tjc utcrus wjdgj ds
rcgcptdvc te dmp`lbtltdeb fer eb`y 1-3
alys.
  Gerpus `utcum wd`` bet actcrderltc
  :-<< alys lftcr evu`ltdeb tjc k`lstegyst
lttlgjcs dtsc`f te tjc cbaemctrdum9
tjcb tjc gebgcptus
gebgcptus ds ds rcfcrrca te ls lb
cmkrye.  Gebtdbucs te ferm)8
   Cmkrye—s eutcr `lycr = trepjek`lst,
nrews rlpda`y, fermdbn 1 pretcgtdvc
`lycrs (mcmkrlbcs) lreuba tjc
cmkrye.
   Qrepjek`lst mcmkrlbcs ‗  lppclr, lba jcla jldr mly
l.  Ebc preaugcs k`eea gc``s
k.  L ;ba acvc`eps dbte tjc
umkd`dgl` gera  fc`t ky tjc metjcr. Qjc fctus
g.  L 7ra, tjc lmbdeb9 pretcgtdvc
f`uda-fd``ca slg
a.  L 1tj, tjc gjerdeb, acvc`eps dbte
tjc p`lgcbtl, wjdgj wd`` scrvc ls
lb dbtcrflgc wdtj tjc metjcr
   Qjc gjerdeb scgrctcs
gjerdeb scgrctcs tjc jermebc
jumlb gjerdebdg neblaetrepdb (jGN)
   JGN tlics tjc p`lgc ef @J lba
`utcum 
mldbtldbs tjc gerpus `utcum  nrewtj s`ews aewb lba mevcs
   Qjc jumlb gjerdebdg neblaetrepdb
stcps db te dbgrclsc tjc preaugtdeb ef
cstrencb lba prencstcrebc. Dt l`se
supprcsscs yeur dmmubc systcm te
suppert yeur nrewdbn klky.
   Lftcr lkeut 7-1 mebtjs ef prcnblbgy,
gerpus `utcum acncbcrltcs 
acncbcrltcs 
   _`lgcbtl bew preaugcs dts cstrencb
lba prencstcrebc lba mldbtldbs
mldbtldbs
cbaemctrdum
  Wtdmu`ltca fdrst ky jGN lba `ltcr ky tjc
p`lgcbtl, cstrencb jc`ps tjc utcrus
nrew, rcnu`ltcs tjc preaugtdeb ef
etjcr icy jermebcs, lba trdnncrs tjc
acvc`epmcbt ef klky—s ernlbs 
  Lmebn dts mlby etjcr purpescs,
nrewtj lba `ltcr jc`ps seftcb
`dnlmcbts lba glrtd`lnc te prcplrc yeu
fer `lker.
  Fdrst trdmcstcr (Mebtjs <-7) (Dbdtdl`
acvc`epmcbt lba rlpda nrewtj)8
e  Lt tjc cba ef tjc fdrst mebtj,
tjc cmkrye jls l jclrtkclt, l
twe-`ekca krldb, lba l spdbl`
gera.
e  Ky tjc cba ef tjc scgeba
mebtj, tjc cmkrye ds
rcgenbdzlk`c ls l jumlb lba ds
gl``ca l fctus

  Wcgeba trdmcstcr (Mebtjs 1-6) (Fctus
e  Ky tjc cba ef tjc feurtj
f eurtj mebtj,
fdbncrbld`s, tecbld`s, cyckrews,
lba cyc`lsjcs jlvc acvc`epca.
Qcctj kcndb te ferm, `dps
kcndb te nrew.
e  Mevcmcbt ef tjc fctus glb kc
glb kcba dts lrms lba mlic l
fdst. Aurdbn tjc
tjc fdftj mebtj,
mebtj, tjc
jclrtkclt glb kc actcgtca ky l
stctjesgepc.
  Qjdra trdmcstcr (Mebtjs >-4) (Nrewtj)8
e  Ky tjc scvcbtj mebtj = `lbune
lppclrs eb tjc klky
e  Ky tjc cdnjtj mebtjs fctus
dbte l jcla-aewb pesdtdeb.
e  Ky tjc bdbtj mebtj tjc fctus ds
fu`` tcrm. Widb ds smeetj lba
wlxy `eeidbn. @lbnue areps eff.