Review - Clinical IX (Cardiology & Derma)

Aggressive Viking Metal, Pagan Metal, neoclassical metal

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V5.5

[Intro: Fast, crushing double kick drums explode. Dark, massive orchestral strings swell. Intense growling vocals introduce the sonic assault.]

[Verse 1: Relentless blast beats. The male vocals deliver the lines with fierce rage.]
L.B.B.B. “Long Q.R.S., Dominant S in V1 one one one, Broad R  broad in lateral leads”. yeah
R.B.B.B. “Long Q.R.S., RSR’ in V1-3 (M-shaped), Wide, slurred S in lateral leads”  m shape M  m M, slurred

Niacin causes flushing "avoid alcohol", pruritus and dyspepsia

Statin-associated muscle symptoms. If moderate/severe symptoms or C.K. levels 4 times great, greatest. , STOP STATIN, stop it, stupid

Water bottle heart seen in large very big pericardial effusion. Water yeah water

[Chorus: Epic orchestral strings soar. The vocals reach a furious peak.]

ENDOCARDITIS endo endo prophylaxis “Amoxicillin”. FOR manipulation of gingival tissue, incision or biopsy of respiratory mucosa (tonsillectomy, adenoidectomy), procedures involving infected skin .
Prosthetic cardiac valve. Previous, relapsed, or recurrent endocarditis; Unrepaired cyanotic congenital heart disease, repaired congenital heart with prosthetic material.

[Guitar & Violin Duel: Neoclassical guitar riffs trade licks with a blazing Paganini-style virtuoso violin solo, executing complex, lightning-fast arpeggios over furious double-kick drumming.]

[Verse 2: The relentless metal assault continues, mixed with dark orchestral textures.]

Abdominal aortic aneurysm, aneurysm aneurysm one-time SCREEN by U.S.G. in men 65-to 75 with history of smoking. Lower B.P. Repair after 5.5.
Follow-up every 2-3 years below low 4 cm. Every year below 5, every 6 months over 5 , 5.

Subclavian-vertebral artery steal syndrome, “syncope during arm use”. Atherosclerosis, congenital or iatrogenic. steal it, steal it

Seborrheic keratosis. “Rare before 30 years, warty surface “stuck on” appearance”. Most frequently on face, upper trunk. Leser–Trélat “gastric and colon cancer – rapidly, large numbers”. Seborrheic seb seb  stucked, I want to get rid of it, get rid of it

[Instrumental Bridge: Aggressive bassline and pounding drums drive a chaotic neoclassical string section, building tension.]

[Verse 3: Intense, growling vocals over a barrage of heavy guitars and rapid drums.]
*Psoriasis. Triggers “infection, alcohol, stress”. not severe pruritus, Auspitz sign, oil drops & nail pitting, relapsing-remitting. Pustular eruptions, erythroderma. Mucosal involvement rare.  Auspitz once more

Plaque psoriasis “the most common”. Salmon colored, covered in silvery white scales. If multiple symmetrically over the scalp, trunk and extensor surfaces of the limbs. Post-inflammatory hypo or hyperpigmentation.
Acute Guttate Guttate Guttate “Disseminated, generalized, mainly trunk”. Pustular and inverse “genital” types
TREAT Coal tar, dithranol, topical steroid, vitamin D, U.V.B. or P.U.V.A., cyclosporin, anti-T.N.F., anti-I.L.17 and 23

[Guitar & Violin Duel 2: An even more chaotic and powerful neoclassical face-off between the guitar and violin, pushing the limits of speed and aggression.]

[Verse 4: The final barrage of fury, with explosive drums and shouting vocals.]

Basal cell carcinoma cancer cancer “a papule or nodule with a central erosion, “pearly” with telangiectasia”. Biopsy then Imiquimod and 5-Fluro U. you you, for some cases, mostly curettage and electrodesiccation, excision, or Mohs micrographic surgery, make Mohs more mohs, meow

Cellulitis, treat I.V. If M.S.S.A. - nafcillin lee lee lee, cefazolin. If M.R.S.A. “vancomycin, linezolid, clindamycin”.

Erysipelas “a superficial cellulitis by beta-hemolytic strep. Bright red patch form sharp, glistening, hot plaque. Oral penicillin, dicloxacillin, cephalexin, clindamycin

Erysipeloid low it low it “benign infection by Erysipelothrix, cellulitis of fingers or the backs in fishermen and meat handler

Lichen planus treat by topical corticosteroids. use it use it

[Outro: Explosive drum and guitar crescendo. The dark orchestra reaches its climax before a final, heavy chord fades to total silence.]

4068/7500

[Intro: Fast, crushing double kick drums explode. Dark, massive orchestral strings swell. Intense growling vocals introduce the sonic assault.] [Verse 1: Relentless blast beats. The male vocals deliver the lines with fierce rage.] L.B.B.B. “Long Q.R.S., Dominant S in V1 one one one, Broad R broad in lateral leads”. yeah R.B.B.B. “Long Q.R.S., RSR’ in V1-3 (M-shaped), Wide, slurred S in lateral leads” m shape M m M, slurred Niacin causes flushing "avoid alcohol", pruritus and dyspepsia Statin-associated muscle symptoms. If moderate/severe symptoms or C.K. levels 4 times great, greatest. , STOP STATIN, stop it, stupid Water bottle heart seen in large very big pericardial effusion. Water yeah water [Chorus: Epic orchestral strings soar. The vocals reach a furious peak.] ENDOCARDITIS endo endo prophylaxis “Amoxicillin”. FOR manipulation of gingival tissue, incision or biopsy of respiratory mucosa (tonsillectomy, adenoidectomy), procedures involving infected skin . Prosthetic cardiac valve. Previous, relapsed, or recurrent endocarditis; Unrepaired cyanotic congenital heart disease, repaired congenital heart with prosthetic material. [Guitar & Violin Duel: Neoclassical guitar riffs trade licks with a blazing Paganini-style virtuoso violin solo, executing complex, lightning-fast arpeggios over furious double-kick drumming.] [Verse 2: The relentless metal assault continues, mixed with dark orchestral textures.] Abdominal aortic aneurysm, aneurysm aneurysm one-time SCREEN by U.S.G. in men 65-to 75 with history of smoking. Lower B.P. Repair after 5.5. Follow-up every 2-3 years below low 4 cm. Every year below 5, every 6 months over 5 , 5. Subclavian-vertebral artery steal syndrome, “syncope during arm use”. Atherosclerosis, congenital or iatrogenic. steal it, steal it Seborrheic keratosis. “Rare before 30 years, warty surface “stuck on” appearance”. Most frequently on face, upper trunk. Leser–Trélat “gastric and colon cancer – rapidly, large numbers”. Seborrheic seb seb stucked, I want to get rid of it, get rid of it [Instrumental Bridge: Aggressive bassline and pounding drums drive a chaotic neoclassical string section, building tension.] [Verse 3: Intense, growling vocals over a barrage of heavy guitars and rapid drums.] *Psoriasis. Triggers “infection, alcohol, stress”. not severe pruritus, Auspitz sign, oil drops & nail pitting, relapsing-remitting. Pustular eruptions, erythroderma. Mucosal involvement rare. Auspitz once more Plaque psoriasis “the most common”. Salmon colored, covered in silvery white scales. If multiple symmetrically over the scalp, trunk and extensor surfaces of the limbs. Post-inflammatory hypo or hyperpigmentation. Acute Guttate Guttate Guttate “Disseminated, generalized, mainly trunk”. Pustular and inverse “genital” types TREAT Coal tar, dithranol, topical steroid, vitamin D, U.V.B. or P.U.V.A., cyclosporin, anti-T.N.F., anti-I.L.17 and 23 [Guitar & Violin Duel 2: An even more chaotic and powerful neoclassical face-off between the guitar and violin, pushing the limits of speed and aggression.] [Verse 4: The final barrage of fury, with explosive drums and shouting vocals.] Basal cell carcinoma cancer cancer “a papule or nodule with a central erosion, “pearly” with telangiectasia”. Biopsy then Imiquimod and 5-Fluro U. you you, for some cases, mostly curettage and electrodesiccation, excision, or Mohs micrographic surgery, make Mohs more mohs, meow Cellulitis, treat I.V. If M.S.S.A. - nafcillin lee lee lee, cefazolin. If M.R.S.A. “vancomycin, linezolid, clindamycin”. Erysipelas “a superficial cellulitis by beta-hemolytic strep. Bright red patch form sharp, glistening, hot plaque. Oral penicillin, dicloxacillin, cephalexin, clindamycin Erysipeloid low it low it “benign infection by Erysipelothrix, cellulitis of fingers or the backs in fishermen and meat handler Lichen planus treat by topical corticosteroids. use it use it [Outro: Explosive drum and guitar crescendo. The dark orchestra reaches its climax before a final, heavy chord fades to total silence.]

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