Site Evaluator Reflection

Site Evaluator: Fahim Sadat

I presented the following case at my site evaluation:

41 yo AA female with pmh of asthma, IDA, vitamin D deficiency, furuncle of back, asthma, HLD and obesity presents c/o abdominal pain x 3 months. Pt states since 01/2021 she has experienced intermittent, generalized abdominal pain. Pt states pain occurs in relapsing/remitting pattern. She can’t point to specific foods as a trigger or exacerbating/alleviating factors. Pt denies use of OTC agents for symptom relief. States this past week she experienced 2 bouts of 10/10 abdominal pain which influenced her to seek evaluation. Pt denies N/V/D, constipation, pregnancy (LMP 3/9/2021), acid reflux, pelvic abnormality, abnormal uterine bleeding or irregular menstrual cycle.

Patient denied any allergies and states only significant family history is for hypertension. She admits to occasional alcohol use and denies smoking tobacco or other illicit drug use. Patient denied any pertinent positives in review of symptoms besides for her abdominal pain.

Upon physical exam, patient’s vitals included: BP – 140/90, RR – 16 breaths/min unlabored, HR – 86 bpm regular rhythm, temp – 97.8 degrees F, O2 sat – 98% on room air and BMI – 41.02. Her whole PE was normal; she had normoactive bowel sounds in all four quadrants, no bruits, patient denied any tenderness upon palpation throughout, rebounding or guarding.

Upon a normal PE the etiology of her abdominal pain remained highly unclear. Patient had blood drawn, was given a referral for an abdominal ultrasound and scheduled for follow up with labs in 1 week.

Professor Sadat gave meaningful feedback and critique, which helped me better understand my patient and her history, especially regarding her family history of fibroids. He asked thought provoking questions and allowed me time to think carefully. The discussion that he led regarding my journal article of choice on uncontrolled asthma broadened my knowledge about asthma and its step-wise approach, especially in patients who are refractory to treatment. I believe this site evaluation, along with my peers rotating in Family Medicine, was beneficial in my learning of this specialty.

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