I presented this H&P at my second site evaluation with Dr. Saint Martin: 27 y/o Hispanic male, unemployed, domiciled with parents, with a PPHx of Bipolar Disorder BIBEMS/NYPD (not under arrest) from a bodega after exhibiting manic behavior. Patient has a history of medication non-compliance, is aware of his Bipolar diagnosis but states “I want to go home, I don’t know why I’m here.” When questioned why he’s here patient repeatedly states that he didn’t do anything, says he takes his Depakote but then later states “I’m lying I don’t take any medication.” Patient is grandiose, repeatedly states “I know …

I presented an article on the “Efficacy and Tolerability of Atypical Antipsychotics for Acute Bipolar Depression: A Network Meta-Analysis.” This systematic review consisted of randomized controlled trials studying the effects of AAPs for the treatment of acute bipolar depression. Primary efficacy outcome was change from baseline in the MADRS total score reported at week 8 or before. The results showed that AAPs including Lurasidone, Quetiapine, Olanzapine and Cariprazine were found to be more efficacious than placebo. Overall, Lurasidone was found to be most effective – it had significantly greater odds of response than other AAPs, NNT for response to treat …

Clinical Scenario:  A 37 y/o Orthodox Jewish woman G5P3104 at 12+1 weeks of gestation presents to her obstetrician for a routine prenatal visit. Her OB tells her that as she nears the end of her first trimester, Noninvasive prenatal testing (NIPT) is indicated. He explains that NIPT is antenatal screening based on bloodwork done after 10 weeks of gestation to identify any chromosomal abnormalities in the fetus.  She declines due to her religious beliefs against prenatal testing.  Cultural factors that need to be considered:  -Although prenatal screening is routinely done for many women during their prenatal and antenatal care, there …

My sixth rotation was OBGYN at Queens Hospital Center. I was very excited going into the rotation as this specialty was most interesting to me during didactic year. Being able to learn about OBGYN in summer semester and then put those lessons into practice and experience both sides of obstetrics and gynecology was pretty amazing. My favorite aspect of this rotation was that because my placement was inpatient, I was able to spend time on the labor and delivery floor, with the gynecology team and in clinic, which was more of the outpatient aspect of OBGYN. This gave me experience …

KH is an 18 y/o G1P0 at 36w6d who presents to L&D triage for evaluation to rule out preeclampsia. Patient was seen in the clinic yesterday and was noted to have elevated blood pressure of 153/85 and sent to triage. At present, she denies any complaints, any HA, blurry vision, chest pain, shortness of breath, epigastric pain or RUQ pain. She denies vaginal bleeding, contractions or leakage/loss of fluid. Patient reports good fetal movement.  Notably blood pressures in triage yesterday were noted to be persistently elevated in the mild range of 140’s-50’s/90’s and was noted to have had one severe …

I presented an article on labor induction vs dilation & evacuation for second-trimester abortion. Included in the reasons for the abortion was fetal anomalies or IUFD, intra-uterine fetal demise/death. Results from the article showed that dilation & evacuation was found to be much safer and more effective than labor induction for second-trimester abortions; labor-induction abortion was associated with higher complication rates, including retained placenta or failed labor induction at 48 hours, than did D&E.

H&P 1:  Identifying Info:  Name: SA Sex: Female Date of Birth: 1/21/1972, 49 y/o  Date & Time: 10/21/21, 7:45 am  Location: Queens Hospital Center  Marital status: Married  Source of Information: Self, reliable  Mode of Transport: Self  Chief Complaint: abdominal pain since yesterday at 11:30 pm   HPI: SA is a 49 y/o G2P0010 F with primary infertility at 18w2d of gestation by embryo transfer with an estimated date of delivery: 3/21/22. Patient presents complaining of intermittent, non-radiating, lower right abdominal pain since last night at 11:30 pm. Since then, it has not worsened. Patient states she hasn’t felt fetal movement since late …