You’re a PA student on your ER rotation. A patient arrives and your attending sends you to see him and report back. 51 y/o M w PMH of GERD and kidney stones presents to ED with a c/o 8/10 chest pain Radiation: positive: left arm, neck, stomach and ear Timing: Since 5 am (it’s 9:30am now) Character: sharp, stabbing, pressure-like Relieved by leaning forward? No Pleuritic: No, does not get worse w inspiration How did it start? Woke him up from sleep Cough, SOB? No History of VTE? No No fever, chills, vomiting but yes to nausea Has never happened …

Psychiatry is so different from any other specialty. It is the place where I got to most work on my interpersonal relationship skills as very often patients were uncooperative and sometimes even aggravated and violent. Learning how to decelerate volatile situations was extremely useful and exciting.     At first it was a bit difficult to fit in as, as in the other places, it was a small microcosm of people who work very tightly together, and a new influx of people may seem like a distraction in a busy ER setting facility. However, once I showed initiative and interest, things …

HPI #3 T.M IDENTIFICATION:   T.M.                                 Sex:       F              Race: Bengali           Nationality:   US         Age:20      Marital status: Single Address:     N/A        Religion: N/A PCD: N/A                    Date: 06/24/21 Informant: self                                   Reliability: reliable                              Referral: self CC: Bizarre Behavior 20 y/o Bengali female with no reported past psychiatric history, past medical or history of substance abuse, domiciled with family, in 12th grade high school BIBEMS activated by sister due to bizarre behavior. Patient states “I don’t know why I’m here”, and says her sister called 911 because patient was “feeling sick” and throwing up. Patient believes her phone and emails are being hacked because someone wants to …

Psychiatry Article Summary Amantadine and Modafinil as Neurostimulants Following Acute Stroke: A Retrospective Study of Intensive Care Unit Patients Citation: Leclerc AM, Riker RR, Brown CS, May T, Nocella K, Cote J, Eldridge A, Seder DB, Gagnon DJ. Amantadine and Modafinil as Neurostimulants Following Acute Stroke: A Retrospective Study of Intensive Care Unit Patients. Neurocrit Care. 2021 Feb;34(1):102-111. doi: 10.1007/s12028-020-00986-4. PMID: 32435964; PMCID: PMC7239352. Neurostimulants may improve or accelerate cognitive and functional recovery after intracerebral hemorrhage, ischemic stroke, or subarachnoid hemorrhage, but few studies have described their safety and effectiveness in the intensive care unit (ICU). The objective of this …

 During this rotation’s site evaluation, I presented 2 HPIs, 5 Pharm cards and a research article. For my HPIs I chose patients with very interesting presentations, one of which was still in treatment and her diagnosis was difficult to make.      My first patient had Borderline Personality Disorder with an overlying Major Depression who came to us after a suicide attempt. She was confident she would be discharged but given her history of self-harm our team decided to admit her. Following her case was very interesting because she was prescribed Topiramate and underwent a Dialectical Behavioral therapy, which, as I …

PICO Search Assignment Worksheet                Name: Christina Shamrock Brief description of patient problem/setting (summarize the case very briefly) A 35 y/o woman came to her Family medicine doctor and brought her 4 y/o son who is being observed for a developmental delay. Her family has recently immigrated from China. She is wondering if the fluoride added to the drinking water possibly caused and continues to influence her child’s neurocognitive development delay and considering installing a water filter. Search Question: Does fluoride added to drinking water cause neurocognitive development delay and lowered IQ levels in pediatric population of 4 years old? Question …

Long Term Care requires a very thorough approach to patient care, and a bit different one from others. During my site evaluation I presented two HPIs, 10 pharm cards and a journal article pertaining to my patient’s condition. A useful feedback I received was about the date my article was published,- even though it was a good study, having it be almost 10 years old makes one question whether there’s new, more accurate data, available. Moving on, I will only chose the most current articles answering my questions.      I have learned new techniques to a Neurological exam approach and …