Bueno para echar leña al fuego, acá les paso lo que dice Harry sobre la fucking hipercalcemia y el PSA
PSA en el archivo adjunto; basicamente es A-N-U-A-L: "The American Cancer Society (ACS) recommends that physicians offer PSA testing and a DRE on an annual basis for men older than age 50 years with an anticipated survival of >10 years; this includes men up to age 76 years"
Sobre la hipercalcemia:
"The various therapies for hypercalcemia are listed in Table 353-4. The choice depends on the underlying disease, the severity of the hypercalcemia, the serum inorganic phosphate level, and the renal, hepatic, and bone marrow function. Mild hypercalcemia [3 mmol/L (12 mg/dL)] can usually be managed by hydration. Severe hypercalcemia [≥3.7 mmol/L (15 mg/dL)] requires rapid correction. Calcitonin should be given for its rapid, albeit short-lived, blockade of bone resorption, and IV pamidronate or zolendronate should be administered, although its onset of action is delayed for 1–2 days. In addition, for the first 24–48 hours, aggressive sodium-calciumdiuresis with IV saline should be given and, following rehydration, large doses of furosemide or ethacrynic acid, but only if appropriate monitoring is available and cardiac and renal function are adequate. Otherwise, dialysis may be necessary. Intermediate degrees of hypercalcemia between 3 and 3.7 mmol/L (12 and 15 mg/dL) should be approached with vigorous hydration and then the most appropriate selection for the patient of the combinations used with severe hypercalcemia"
El/la urolog@ y endocrinolog@ que mandaron las preguntas deberian volver a hacer el examen de residencia a ver si pueden adjudicar como R1 en el hospital de Monte Chingolo