Man why you even got to do a thing

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Special Bonus

-No Healing Touch - 100
-Completed with 120 left - 800
-No mistakes - 900
-Max chain over 100 - 200

You'd think extreme Pempti would be some kind of ruthless death-on-wheels speed demon. But turns out he's actually very similar to the last one you fought. So we're going to approach this operation the same way as the last Pempti:

Go inside. Don't worry about raising vitals yet. When you're in, immediately fill up your syringe with the serum and inject it into the circle of Pempti cells before it disappears. After injecting once, switch to the stabilizer and raise vitals to max with a single injection on the right. Then switch back to the serum and inject the circle a second time. This will cause the Pempti core to reveal itself. Switch to your new laser now and begin burning the core.

Once you get the first OK it'll be time to fight Pempti mano a mano. To kill it, you have to keep burning the core with the laser. But Pempti defends itself by sending out its minions to wreak havoc on the patient's lung. You can't ignore the minions or they'll kill the poor guy in mere seconds. You have to kill them with the laser as well.

As a general rule, always, always, ALWAYS have your laser activated and right on the core when you're not dealing with minions. This is because this is where they come out from. you don't really know what Pempti will send out next, so having the laser activated and pointing on the core puts you in the best possible position to fight whatever it's going to send out on the shortest notice.

Now Pempti has 3 kinds of minions that it likes to send out. The first type are red mini-cores that cause lacerations. These are the ones that can cause the most damage if you don't take care of them, but they're also not too hard to deal with. Pempti will send 5 of these, one right after the other. They will move from the center (that is, where the core is located) to one of 5 spots around it, then shoot upwards after a second and create a laceration on the lung. You don't want this to happen. Your goal is to kill every one of these 5 small cores BEFORE they get a chance to create their laceration. This isn't hard to do if you're on the ball, but the timeframe from their creation to the laceration is a little bit strict so your laser NEEDS to be active and pointing at the core BEFORE it sends the first one out. Otherwise there's a good chance that you won't have enough time to kill it before it does damage. You can probably suture one or two lacerations if you're fast enough, but ideally you don't want to give Pempti a chance to create even ONE. The problem is that if you try to suture after all 5 of them have gone out, it's probable that you will not be pointing the laser at the core when it sends out the next wave, meaning you will NOT have time to deal with it, and you will be even closer to being overwhelmed. So it's in your best interest to kill these little guys immediately. To do this, as I've said before, have your laser burning the core before they come out. This makes it so that you start burning and causing damage to it as it's coming out, and you can follow its path with the laser up to one of the 5 points where it preps to make the laceration, burning it the entire time. If you do this, you will kill it before it does the laceration. But you can't relax because there's still 4 more to come after that one, so very quickly go back to the center and repeat the same thing for all of them. Remember, don't let even ONE of them get past.

The next type of Pempti minions are blue ones that cause tiny tumors. Now if you'll notice, the laser has an area of effect. This means that you can actually kill two of these little cores at the same time by pointing the laser BETWEEN them. If you're good, you can consistently kill all of them every time by doing this. But this is not really what you want. You want extra points.

Believe it or not, extreme Pempti happens to be easier than the others in this regard. Since it has so much HP (thus the operation lasts longer), you actually only need to leave a single one of these blue mini cores alive each time and you will get the points you need. Therefore, the way you want to treat these little guys is as follows:

Your laser should always be pointing at the core. As soon as you see it send out these mini cores, bring your laser up a little bit and place it in between the two mini cores there. That should kill them both in one shot, then quickly move to the right and place the laser in between the two mini cores there. That should also kill them both in one shot. If you do this correctly, all the mini cores except for the single one on the far left should die before they can attack. Before the survivor attacks, switch to the gel and begin applying it over the part where you think it will create its tumors. Not only does this raise vitals slightly but it preps you up to treat them because if you laser them while the gel is still active the holes will be patched up instantly. Obviously if the gel hasn't disappeared your view is blocked, so you kind of have to guess where the tumors are and do sweeping motions with the laser up and down that part. If you miss one or two, don't worry, just treat them immediately before killing the survivor or quickly right afterwards. Since it's only one guy, you shouldn't have problems patching up the strangler tumors and killing it before it gets a chance to create a second set.

The third type of minion Pempti uses is the least dangerous one. They are 5 mini cores that slowly come out in a spiral and start spinning around and causing damage. The thing is, these pose absolutely NO problem if you're pointing the laser at the core (which you should be). If you are, you don't need to do anything. All 5 mini cores will die as they're coming out before they have a chance to know what's up. No sweat.

These guys are notable in that, right after killing all five, it's a pretty good opportunity to raise vitals back up to max. I'd recommend doing only a quick half-injection before going back to lasering the core though. Vitals shouldn't be dropping too much in this operation, so a half injection should be pretty much all you need to get them back up to 99. You can do a full injection if you want, though that might be pushing it a tiny bit.

In any case, that's how you fight Pempti. If you keep the laser at the core you should finish before the time limit. You shouldn't even have to raise vitals much or at all at the end.