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 …

A COMPARISON OF RATE CONTROL AND RHYTHM CONTROL IN PATIENTS WITH ATRIAL FIBRILLATION    ~NEJM Citation: Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, Kellen JC, Greene HL, Mickel MC, Dalquist JE, Corley SD; Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2012 Dec 5;347(23):1825-33. doi: 10.1056/NEJMoa021328. PMID: 12466506. https://www.nejm.org/doi/pdf/10.1056/NEJMoa021328?articleTools=true A-fib: MC sustained arrhythmia. Problem: poorly controlled/irregular ventricular rate Tx goal: NSR maintenance There are two approaches to the treatment of atrial fibrillation: one is cardioversion and treatment …

Christina Shamrock Nice job on this.  Good capture of information, sequencing and particularly good pursuit of the specifics on PE relevant to the chief concerns.  Could use a little more exploration of the fall and note my comments on the assessment and imaging information how it might be placed/discussed differently MEDICAL HISTORY #1                                               Date:        05/11/21                   Time: 11:00 IDENTIFICATION:       O.H.                            Sex:          M           Race:   Indian            Nationality:    US        Age: 69   Marital status: Married Address:        N/A                               Religion: N/A PCD: Dr.Bhangoo, MD Informant : self                            Reliability:          reliable                    Referral:  none HPI:       A 69 y/o M w a medical Hx of being an active smoker, COPD, …

  I had my Long Term Care rotation in the Internal Medicine department. During my 4 weeks there I got to work with two different attendings with an entirely different approach to patient care, so it was very interesting to participate in both. This was my 4th rotation, so I was definitely feeling more confident and was not afraid to speak up to ask questions or ask to do procedures, so I did not really note any interpersonal challenges. QHC staff is very friendly and willing to teach, and I got clear guidelines on what were the expectations of me …

FM Site Visit Summary         For my first HPI I chose the most exciting case I saw during my rotation – a decompensating heart failure patient that ended up being transported to the ER. He was a young male with a PMH of DM2 and HTN who was already s/p renal transplant. During the site visit my preceptor asked leading questions that made me think of all possible etiologies of his condition which was very stimulating. Prof.Sadat also laid out the possible treatment plan for my patient once he reaches the ER which gave me a sense of completeness since …