4. Typhon Posting Report
Author: Sijia Wang
PA Student from York PA Program
Surgery-Article PDF Document and Summary
van Dijk ST, van Dijk AH, Dijkgraaf MG, Boermeester MA. Meta-analysis of in-hospital delay before surgery as a risk factor for complications in patients with acute appendicitis. Br J Surg. 2018 Jul;105(8):933-945. doi: 10.1002/bjs.10873. PMID: 29902346; PMCID: PMC6033184. 2. in-hospital delay before surgery Article Summary Emergency appendicectomy is the standard of care in the treatment of acute appendicitis. However, some studies have reported higher morbidity and error rates when working or operating at night. So, if patient presents at nighttime with acute appendicitis. Do we have to perform a night-time surgery immediately? This systematic review aimed to assess in-hospital delay …
Surgery-SOPA Note 3
CC: I have an abdominal pain x 1 week Subjective: 51 years old male with PMHx antiphospholipid syndrome, hx DVT/PE, seizure, colonic perforation, abdominal wound infection, presents with a chief complaint of low abdominal pain. According to the patient, the pain began approximately 7 days prior in the area just above this umbilicus and radiated laterally to his right lower quadrant. He describes the pain as intermittent, dull discomfort, rates as 3/10 at beginning, but he did not pay much attention, or take any medication at that time. Patient states about 3 to 4 days later, his abdominal pain became …
Surgery-SOPA Note 2
CC: I have a hernia that needs to be repaired Subjective: 63-year-old obese male with PMHx includes HLD, HTN, DM, diverticulosis, former cigarette smoker (recently quit), shingles. Presents to PAT prior to scheduled Open Incisional Hernia Repair with Ovitex Mesh Dr. Denoto on 9/28/2020. Patient is s/p colon resection with colostomy (2012), reversed colostomy and diverting loop ileostomy (2013), ileostomy reversed 3 months later. Patient reports he has a mass protruding through the abdomen over the abdominal incision. He reports the hernia has gotten larger over the last several months. He wears a belt to keep the mass from popping …
Surgery-SOPA Note 1
CC: I am scheduled for gall bladder surgery Subjective: A 67-year-old male with PMHx HTN, HLD, Arthritis, Cervical Spinal Stenosis, Fatty Liver, Diverticulosis, GERD, History of Kidney Stones, BPH, Environmental and Seasonal Allergies. Patient presents to PAT today prior to scheduled Laparoscopic Cholecystectomy by Dr. Denoto on 10/5/2020. Patient reports “intermittent” right upper quadrant abdominal pain in past 2 months. He describes the pain as cramping, and last about 20 to 30 minutes for each episode. He localizes the pain to his epigastric area and states that it radiates to his right upper abdomen. He also complains nausea associate with …
AM-Site Evaluation Presentation Summary
In the mid-rotation evaluation site visit, I presented two cases on cervical radiculopathy and angina pectoris. For the angina pectoris patient, he was a 65 years old male who was suffering from multiple episodes of pain as pressure and tightness. I think the case was interesting because the patient was experienced a classic presentation of stable angina. We did the ECG in office which show regular sinus rhythm, and then sent the patient to the ED for further work up and evaluation. My site evaluator, Professor Malavet, also discussed the patient disposition, which I found to be very helpful. Then …
AM-Rotation Reflection
Types of patients you found challenging in this rotation and what you learned about dealing with them I found the most challenging in this rotation is that hard to have productive encounters when patients exhibit the angry, defensive, frightened or resistant patients. When I see these signs, try to uncover the source of difficulty for the patient and pay attention to the way his or her emotions relate to the medical issues at hand. For example, a patient who is in pain and has been waiting for an hour might be quite angry when I finally get to the room. …
AM-Typhon Patient Encounter
4. Typhon Posting Report
AM-Article PDF Document and Summary
Probiotics for the prevention of antibiotic-associated diarrhea and Clostridium difficile infection among hospitalized patients: systematic review and meta-analysis. 2. Article – Probiotics for the prevention Citation: Pattani R, Palda VA, Hwang SW, Shah PS. Probiotics for the prevention of antibiotic-associated diarrhea and Clostridium difficile infection among hospitalized patients: systematic review and meta-analysis. Open Med. 2013;7(2):e56-e67. Published 2013 May 28. Article Summary: Antibiotics can disturb gastrointestinal microbiota which may lead to reduced resistance to pathogens such as Clostridium difficile. A rise in the use of antibiotics has resulted in a marked increase in antibiotic-associated diarrhea. Probiotics are live microbial preparations that …
AM-SOAP Note 3
CC: right ear discharge x 5 days Subjective: 68 years old female with PMHx HTN, depression, presents to the clinic for ear discharge. Patient notices odor less yellowish discharge from her right ear 5 days ago without any pain. Patient complains right ear fullness with mild itching. She states she had been experienced the same symptoms almost once per year. The last episode of ear infection happened two years ago. She cleans her ear wax once per year and the last ear wax removal was done last year. She also complains lightheadedness associated with her ear discharge. Denies recent swimming, …
