
Review - Clinical XIX (Oncology & Epidemiology)
[Intro: 160 BPM. A crackling vinyl sound. A rapid snare drum roll kicks off the track, followed immediately by a wild, descending surf-guitar glissando. The full band crashes in with a frantic, bouncy 60s beat. The Frontman yells a classic "One, two, three, GO!"] [Verse 1: The bass pumps a walking line. The Frontman sings with a bright, staccato, punchy delivery, adding rock-and-roll repeats.] (Frontman) * Ovarian cancer; mild nonspecific G.I. symptoms, bloating or pelvic pressure; C.A. 125, transvaginal sonography (Backup Band) (transvaginal sonography!) (Frontman) * Combination oral contraceptives decrease risk of endometrial and ovarian ca, increase breast hepatic adenoma, ca Bloody discharge “suggestive of cancer, more often by a benign papilloma in the duct. Breast Abscess; during nursing; redness, tenderness, and induration. Staphylococcus. Drainage, nafcillin/oxacillin/cefazolin [Verse 2: The Farfisa organ plays a bright, swirling riff on the offbeats. The energy keeps climbing.] (Frontman) * Fat necrosis “after trauma; fat injections”, mimics carcinoma (mimics carcinoma!) U.S.G.; in determining a lesion detected by mammography is solid or cystic & in patients with dense breasts Younger than 30, ultrasound; 30-39 years, mammogram in addition to Ultrasound.; after 40 mammography Cervical cancer screening “21-65 every 3 years with cytology; 30-65 5 years if hr.H.P.V. contesting [Chorus / Breakdown: The drums switch to a heavy tom-tom beat. The Frontman delivers the screening guidelines like a rapid-fire rockabilly chant, while the backup band harmonizes.] (Frontman) A.A.A.; with U.S.G. 1-time in men, 65-75 who have ever smoked Breast cancer; “biennial screening mammography 40-74” Gonorrhea & chlamydia; “all sexually active women before 25 years, after 25 years if increased risk Colorectal cancer “aged 45-75” H.C.V.; “18-79 years.” H.B.V. in increased risk and pregnancy. H.I.V. “15 to 65 years” Hypertension “18 years and older” (Backup Band) (18 years and older!) (Frontman) Lung cancer; annual screening with low-dose C.T. aged 50 to 80 years; 20 pack-year history & smoking within 15 years Osteoporosis “in women 65 years or older” [Guitar Solo: A frantic, highly distorted 15-second surf-rock guitar solo. The tambourine is shaking wildly. The Frontman lets out an energetic "Woooo!"] [Verse 3: The band comes back in hot. The Frontman tackles the statistics with bouncing, rhythmic joy.] (Frontman) * Prevalence is incidence times duration Reliability, precision and; validity “accuracy” standard deviation 1 is 68 percent. 2 is 95.4 . 3 is 99.7 . (3 is 99.7 !) Maternal mortality is pregnancy to 90 days postpartum per live births Hospice; prognosis is less than 6 months or life prolonging treatment is not beneficial [Outro: The band builds to a chaotic, feverish climax. The Farfisa organ screeches and the cymbals crash repeatedly.] (Frontman) * Home health services allow infirmed patients to receive skilled care at home; homebound, use of mobility device , can’t leave home by himself Nonskilled care is bathing, grooming, dressing V.S. Skilled by home health services Caregiver relief program for an overburdened caregiver (Backup Band) (an overburdened caregiver!) [Ending: A classic 60s rock "trash can" ending—everyone playing their instruments as fast and loud as possible for three seconds, culminating in one final, synchronized chord hit. Total silence.]

