Rotation PICO/Mini CAT Question RT 1 – Geriatrics PICO Do NOACs provide effective embolic stroke prevention compared to Warfarin for patients with atrial fibrillation?   RT 1 – Geriatrics PICO Does exercise-based swallow therapy given at weekly intervals improve dysphagia in patients after an acute stroke compared to no therapy?   RT 2 – Internal Medicine PICO Is marijuana use an independent risk factor of adverse cardiovascular events?   RT 2 – Internal Medicine PICO Does hydromorphone (Dilaudid) have better safety & efficacy than Meperidine (Demerol) for the treatment of acute sickle cell pain in a vaso-occlusive crisis?   RT …

My PANCE exam is schedule for January 11th, which means I have exactly one month to prepare after I finish my last rotation. The first weekend will be dedicated to PANCE study prep and then the following week will be the school-provided pance prep pearls review. I am using my surgery rotation to study all of the surgical related material, When looking at my scores based on content break down from Rosh Review, Kaplan, PACKRATs, EOR exams, and the EOC, the trends are not consistent. For example, there are sections of the packrat I scored 100% in but on rosh …

Search Question: Clearly state the question (including outcomes or criteria to be tracked) A 36-year-old female presents to CitiMed for follow-up evaluation and management of injuries sustained from being struck by a motor vehicle while in the crosswalk. She sustained a fracture to her left femur, tibia, and fibula upon impact. She is concerned about how her injuries will heal and states that wants a “quick and speedy recovery back to her baseline” because she is eager to gain functionality in her left work so she can get back to her normal routine. She states the PA at her orthopedics …

History & Physicals: Site Visit Summary: For my first site evaluation, we reviewed two clinical cases and five pharmacology cards. For the first case, I presented an 80 y/o male with a chronic perianal abscess fistulizing to the rectum. The case was complicated by the area being irradiated secondary to prostate cancer along with having multiple comorbidities. The abscess had been previously drained one year prior with seton placement without resolution. The biggest feedback for this case was for me to focus more on the social history including the patients ADLs and IADLs. Since this is a case of an …

History & Physicals: Site Visit Summary: I had two site evaluations on this rotation. Ten pharm cards were created that were tailored to common drugs used in urgent care, one research article, and three H&Ps. During the first, we discussed a case presentation of a patient with a COPD exacerbation. We further delved into common co-occurrences with exacerbations such as the risk of infection and atrial fibrillation and how to manage both. Additionally, we discussed special findings on the pulmonary physical exam such as tactile fremitus, egophony, and whispered pectoriloquy. For my research article, I chose a newly published systematic …

History & Physicals: Journal Article Summary Expert groups have advocated for the screening of pancreatic cancer in high-risk individuals, but prior research establishing if there is a beneficial outcome to screening measures had not previously been performed. Therefore, the multicenter Cancer of Pancreas Screening (CAPS) study aimed to establish the benefits of screening in terms of earlier detection, impact on management, and overall survival outcomes. Over 1700 participants were enrolled and of those individuals, 48.5% had a pathogenic variant in a PDAC-susceptibility gene. The screenings resulted in 1/160 individuals being diagnosed with pancreatic cancer. Of those diagnosed, 57.9% still had …

Clinical Question: While on my Pediatric Rotation, an 18-month-old child presented to the Pediatric Emergency Room with her mother who stated her child has been congested with increased breathing difficulty for the past 3 days. Upon physical exam the patient was in no acute distress with stable vital signs, but auscultation of the lungs revealed diffuse wheezing. The child was diagnosed with bronchiolitis and prescribed albuterol nebulizer treatments along with supportive care. The mother asked if the albuterol would improve her child’s breathing and the Pediatrician advised that there is no consensus on whether or not to use bronchodilators for …

Clinical Question: A 28 y/o female was admitted to the psychiatric emergency room for suicidal ideation. She has a past psychiatric history of post-traumatic stress disorder (PTSD) secondary to sexual assault. Upon interview, she expresses frustration that there was no early intervention provided to help reduce her PTSD symptoms “before they got bad.” Subsequent discussion between the psychiatrist and myself was had. The psychiatrist stated that there is limited effective pharmacologic and even psychologic therapy for PTSD and research should focus on prevention and mitigation immediately after the traumatic incident occurs. PICO Question: In people who experience a traumatic event, …

Rotation Week PICO/Mini CAT Question RT 1 – Long Term Care RT 1, Week 3 PICO Does music therapy improve outcomes of dementia? RT 1 – Long Term Care RT 1, Week 4 PICO Does swallow therapy help improve dysphagia after a stroke? RT 2 – Internal Medicine RT 2, Week 1 PICO NOAC vs Warfarin for stroke prevention in Atrial Fibrillation RT 2 – Internal Medicine RT 2, Week 2 PICO Is marijuana use a cardiovascular risk factor? RT 2 – Internal Medicine RT 2, Week 5 PICO What treatments are effective in managing vaso-occlusive acute sickle cell crises? …