Patient presents to PCP with swelling of the left clavicle persistent for 3 months. Hx of schizoaffective disorder, depression, hypertension and active multiple myeloma. Case goes into consult with multiple physicians. What are considered treatment plans?

For consideration

Heterogenous enlarging left clavicle mass (3.8cmx3.2cm)

Bone marrow suggests plasmacytoma with skewed kappa/lambda ratio, CD138 positive cells (value not reported due to conflicting lab results)

FISH showed 17p deletion.

Labs consistent with previously diagnosed multiple myeloma

Prior treatment included radiotherapy 1 month post initiation of a combination of lenolidomide, bortezomib and dexamethasone

his posts suck and we'd lose nothing from banning him.

@Bruhfunny_Thrall

Got an email asking if I could help as on on-call ER consult to some small school full of a bunch of fricked up r-slurs. 75% are suicidal and the others just yell and scream the second they aren't given whatever they want.

I'm not some charity, I do the bare minimum to be able to practice in the ER, I'm busy as frick paying another favor and people haven't realized I truly don't give a frick. Their and the school value is worth less than my bottle of grey goose.

It's like a week out and during the weekday but sounds like fun. Invite said people like Dan Smith and Phil Ivey were invited but doubt they'll show up. It's a 500k buy-in so I don't even know if Smith can afford it or if Ivey is even in Vegas. Coon and Paul phua are also invited as a maybe since triton is holding a tournament and I think they are playing in that and not interested in a cash game

poopoo

Thank fricking god I'm home and my butler pantry has booze. Turns out fricking off on drunken expeditions and going AWOL isn't looked kindly on so I had frick tons of work to catch up on. I've got like 2-3 months and I plan to spend that time either at home or just signing paperwork playing video games or hiking.

I'm almost a year into this job and this is what they're upset about? I've been smoking every couple hour it's so I don't know how they're just recently finding this out. I play on my PS5 all the time so I don't have to do actual work but apparently that's okay since I'm not smoking. The department I work with most frequently is nothing but stoners that smoke cigarettes any time they have a free minute. They need to grow the frick up and learn that some adults smoke.

imagina defender una Ase💀ina para ir en mi Contra por Dalas Review

Continuing our daily SCENECORE series, today we are showcasing REBZYYX

He(?) has a lot of really good tracks so you can expect to see him again in the coming days

No s*x or nudity, and you can just ignore me except when you're feeding me.

Thx.

https://www.architecturaldigest.in/story/the-sphere-in-las-vegas-5-things-to-know-about-this-dollar23-billion-concert-venue#:~:text=How Much Did It Cost,Sphere ultimately cost $2.3 billion.

Had to fly red eye and still need to do another 30 hours as well as like 400 hours that we cannot legally say and will just be between the medical board and myself. It's going to be over 3 months. Just have me do 115 hour weeks so I can knock it out in a month.

!moidmoment !besties !r-slurs !pings

Her insta is a banger mix of sad and based

GIRL FRENCH KISSES HER DOG. 🤮🤢

Are people starting to show their pets a little too much love? pic.twitter.com/MPidAuT85S

— DramaAlert (@DramaAlert) November 10, 2023