Review - Clinical XXIX (Pancreas + HIV/HCV/HBV)

80s arena rock, hair metal, stadium power ballad

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V5.5

[Verse 1: The guitars lock into a heavy, chugging palm-muted riff. The Frontman delivers the lyrics with gritty, rhythmic attitude.]
(Frontman)

Pancreatic abscess; rising fever, leukocytosis, and localized tenderness!
And an epigastric mass usually 6 or more weeks into the course of acute pancreatitis!
For pancreatic infections; imipenem!
Routine antibiotics to prevent infections in necrotizing pancreatitis is of no benefit!
Pseudocysts, below 6 cm often resolve spontaneously!
If infected or symptomatic, drainage!

[Pre-Chorus: The bass rumbles, and the synthesizers swell. The Frontman builds the tension, holding out his vocal notes.]
(Frontman)
Pancreatic ascites after recovery from acute pancreatitis;
persistant amylase and absence of pain!
High ascitic protein and amylase!
Necrosectomy for necrotizing or infected pancreatitis!

[Chorus / The Pancreas Anthem: The guitars explode into wide, crashing power chords. The Frontman is joined by a massive stadium choir for a soaring, melodic hook.]
(Frontman & Stadium Choir)

Chronic pancreatitis!
Epigastric pain, steatorrhea, weight loss, abnormal imaging!
Confirmed by low fecal elastase!
C.T.; calcifications, ductal dilatation and heterogeneity or atrophy!
Secretin-enhanced M.R.C.P., E.U.S.!
Biopsy as last resort!
Treat; low-fat diet no Alcohol, acetaminophen or N.S.A.I.D.!
Enzyme replacement therapy, prednisone if autoimmune!
Endoscopic therapy or surgery!

[Verse 2: The drums switch to a driving double-time feel. The Frontman spits the exposure guidelines with rapid-fire rock energy.]
(Frontman)

H.B.V. Exposures in Health Care!
If vaccinated and anti-H.B.s above 10;
no postexposure prophylaxis, no H.B.s.A.g. testing the source patient!
If not; H.B.s.A.g. of the exposed negative; and if source patient positive/unknown;
one dose H.B.I.G. and vaccinate!
If source patient negative, just vaccine!
Test baseline then 6 months!

[Pre-Chorus 2: The music strips back to just a glowing synthesizer and the kick drum, building up to the next explosion.]
(Frontman)

H.C.V. postexposure; test anti-H.C.V. & H.C.V. R.N.A.
“within 2 days with the source patient, if patient positive then at 3–6 weeks, and 4–6 months”!

[Chorus 2 / The P.E.P. Anthem: Maximum stadium energy. Pyrotechnics explode (sonically). The vocals are pushed to their absolute limits.]
(Frontman & Stadium Choir)

H.I.V. post-exposure prophylaxis within 72 hours!
If source H.I.V. status unknown, case by case decision!
Tenofovir plus emtricitabine and raltegravir or dolutegravir for 28-days!
P.E.P. also indicated during pregnancy!
Baseline rapid test!
Then test 4-6 weeks, 3 months!

[Bridge / The Face-Melting Guitar Solo: A 20-second blazing, shredding electric guitar solo. Dive bombs, whammy bar squeals, and lightning-fast arpeggios tear through the speakers while the rhythm section pounds relentlessly.]

[Outro / The PrEP Finale: Coming out of the solo, the Frontman belts the final guidelines with everything he has left, stretching the notes into the stratosphere.]
(Frontman)

H.I.V. pre-exposure prophylaxis for sex within six months!
And partner with H.I.V./inconsistent condom usage/S.T.I. diagnosis, drug users sharing needles!
Tenofovir and emtricitabine!
Test H.I.V. every 3 months!
(Screaming)
Test H.I.V. every three... MOOOONNNTTTHHHHSSSS!

[Ending: A chaotic, crashing rock finale. The drummer smashes every cymbal, the guitarists sustain a screeching feedback chord, and a massive sub-bass explosion rumbles the stadium. Total silence.]

3812/7500

[Intro: 120 BPM. A roaring crowd fills the stadium. A lone, heavily distorted electric guitar plays a blazing, fast-fingered solo. The massive stadium drums kick in—BOOM, SMACK, BOOM-BOOM, SMACK. The Frontman lets out a piercing, high-pitched rock scream.] (Frontman) Yeeeeeaaaaaaah! Listen to the protocols! [Verse 1: The guitars lock into a heavy, chugging palm-muted riff. The Frontman delivers the lyrics with gritty, rhythmic attitude.] (Frontman) Pancreatic abscess; rising fever, leukocytosis, and localized tenderness! And an epigastric mass usually 6 or more weeks into the course of acute pancreatitis! For pancreatic infections; imipenem! Routine antibiotics to prevent infections in necrotizing pancreatitis is of no benefit! Pseudocysts, below 6 cm often resolve spontaneously! If infected or symptomatic, drainage! [Pre-Chorus: The bass rumbles, and the synthesizers swell. The Frontman builds the tension, holding out his vocal notes.] (Frontman) Pancreatic ascites after recovery from acute pancreatitis; persistant amylase and absence of pain! High ascitic protein and amylase! Necrosectomy for necrotizing or infected pancreatitis! [Chorus / The Pancreas Anthem: The guitars explode into wide, crashing power chords. The Frontman is joined by a massive stadium choir for a soaring, melodic hook.] (Frontman & Stadium Choir) Chronic pancreatitis! Epigastric pain, steatorrhea, weight loss, abnormal imaging! Confirmed by low fecal elastase! C.T.; calcifications, ductal dilatation and heterogeneity or atrophy! Secretin-enhanced M.R.C.P., E.U.S.! Biopsy as last resort! Treat; low-fat diet no Alcohol, acetaminophen or N.S.A.I.D.! Enzyme replacement therapy, prednisone if autoimmune! Endoscopic therapy or surgery! [Verse 2: The drums switch to a driving double-time feel. The Frontman spits the exposure guidelines with rapid-fire rock energy.] (Frontman) H.B.V. Exposures in Health Care! If vaccinated and anti-H.B.s above 10; no postexposure prophylaxis, no H.B.s.A.g. testing the source patient! If not; H.B.s.A.g. of the exposed negative; and if source patient positive/unknown; one dose H.B.I.G. and vaccinate! If source patient negative, just vaccine! Test baseline then 6 months! [Pre-Chorus 2: The music strips back to just a glowing synthesizer and the kick drum, building up to the next explosion.] (Frontman) H.C.V. postexposure; test anti-H.C.V. & H.C.V. R.N.A. “within 2 days with the source patient, if patient positive then at 3–6 weeks, and 4–6 months”! [Chorus 2 / The P.E.P. Anthem: Maximum stadium energy. Pyrotechnics explode (sonically). The vocals are pushed to their absolute limits.] (Frontman & Stadium Choir) H.I.V. post-exposure prophylaxis within 72 hours! If source H.I.V. status unknown, case by case decision! Tenofovir plus emtricitabine and raltegravir or dolutegravir for 28-days! P.E.P. also indicated during pregnancy! Baseline rapid test! Then test 4-6 weeks, 3 months! [Bridge / The Face-Melting Guitar Solo: A 20-second blazing, shredding electric guitar solo. Dive bombs, whammy bar squeals, and lightning-fast arpeggios tear through the speakers while the rhythm section pounds relentlessly.] [Outro / The PrEP Finale: Coming out of the solo, the Frontman belts the final guidelines with everything he has left, stretching the notes into the stratosphere.] (Frontman) H.I.V. pre-exposure prophylaxis for sex within six months! And partner with H.I.V./inconsistent condom usage/S.T.I. diagnosis, drug users sharing needles! Tenofovir and emtricitabine! Test H.I.V. every 3 months! (Screaming) Test H.I.V. every three... MOOOONNNTTTHHHHSSSS! [Ending: A chaotic, crashing rock finale. The drummer smashes every cymbal, the guitarists sustain a screeching feedback chord, and a massive sub-bass explosion rumbles the stadium. Total silence.]

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