My sixth week of online clinical cases was Pediatrics. We went over 2 cases: one unspecified CAP case and one Kawasaki Disease case. Both presented with unique challenges in diagnosis and forming a treatment plan. Both cases also involved multiple visits, trending labs, and observing changes in presentation over multiple days as we arrived at our respective diagnoses.
The following documents were my HW assignments for this class:
For our fifth week, my group discussed one case in-depth. Our patient was a nonagenarian with limited mobility, CKD, dementia, and hitherto inappropriately diagnosed anemia of chronic illness. We spent a good deal of the week investigating different concerns regarding polypharmacy and renal status in older patients.
The following were my contributions to our discussions:
For our fourth week of online cases, we ran through 5 different cases, each one presented by different group members and our teacher. We each took turns playing the role of the patient, presenting with our respective pathologies that we researched.
Psych-related H&P’s differ from other specialties in that they rely heavily on proper use of the Mental Status Exam (MSE). This is a diagnostic tool used in evaluating the patient’s appearance, mood, perception, thought process, thought content, behavior, judgement, and insight. It is a great tool for organizing and documenting what would be an otherwise difficult constellations of subtleties that cannot be sufficiently captured in a HPI or ROS.
Another component of this week that I enjoyed was a lightning session of going through the more commonly prescribed types of antispychotic, mood stabilizing, and antiepileptic medications, their indications, and common adverse effects. It was a valuable refresher that helped clarify a few “big picture” concepts in psych pharmacology.
Below are the assignments that I completed for this week:
For our third week of online clinical practice, our group discussed one particularly challenging IM case over the course of the week.
Our case was a 23 y/o male with PMHx of DM2, HTN, HLD, chronic stable angina, HCV associated cirrhosis, and dialysis-dependent ESRD. The patient presented with SOB and c/o fatigue x 2 days. It was determined that the patient was severely hyperkalemic and hypervolemic from 2 missed dialysis appointments that week. Patient also presented with anemia of chronic illness and abd rigidness and distention from ascites. Aside from emergent diagnosis and treatment of hyperkalemia, we also had to rule out bacteremia/sepsis, bacterial peritonitis, and Covid-19/PNA.
As a group we went through the entire process of admission, initial w/u and diagnostic studies, emergency dialysis protocols, and subsequent observation and treatment for anemia, HTN, and glycemic control. Between each session, group members were given a topic to research based on our initial differential diagnosis and subsequent assessment and plan.
Below are my contributions to our collective efforts on this case:
For week 2 of online clinical correlations we discussed 3 cases: septic shock associated with foot ulcer, chest pain associated with A-fib w/RVR, and acute pulmonary embolism. The following links to documents of my assigned questions pertaining to each of those cases.
My first week of online clinical cases pertained to surgery. Our discussions and assignments involved the clinical presentation, diagnostic imaging, labs, treatment, and prognosis of the following cases: thyroid cancer, appendicitis, cholecystitis, diverticulitis, pancreatitis, and peripheral arterial disease. Each member of our group was assigned one specific question to research and present based on these cases. I’ve included my presentations below:
Risk Factors for Thyroid Cancer
Appendicitis Case: H&P, Imaging, Labs, Tx, and Orders
Comparison of Indications of Revascularization in PAD, AAA, and Carotid Artery Disease
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