H&P 1   H&P 2

Overall, this rotation was a great transition from my general medicine rotations in family medicine, pediatrics, and OB/GYN, encompassing many things from the rotations (except pediatrics). I felt that the rotation closely mirrored family medicine with the integration of managing patients in SAR (sub-acute rehab), the art of de-prescribing, palliative/comfort-care, and more. During my time in geriatrics, I continued to strengthen my ability to manage multiple chronic conditions simultaneously, similar to family medicine, while further refining my clinical reasoning and medication management skills in elderly patients. One of the most valuable lessons I learned during this rotation was how to …

For my mid-site evaluation, I presented an H&P on a 75-year-old female with a PMHx of HTN, HLD, atrial fibrillation on anticoagulation, type 2 diabetes mellitus, and depression who presented after a witnessed mechanical fall from an unlocked wheelchair with mild right hip/buttock pain. She denied head strike or loss of consciousness and remained able to bear weight, with physical exam only notable for minimal tenderness without deformities or bruising. Given her age and osteoporosis risk factors, occult hip fracture remained on the differential despite relatively benign findings, so a right hip/pelvic XR was ordered along with PT/OT evaluation and …

Article Title: Timing to surgery in elderly patients with small bowel obstruction: An insight on frailty Authors: Li, Renxi, et al. Article Link (see pdf below): https://pubmed.ncbi.nlm.nih.gov/35699126/ The reason I chose this article is that during my geriatrics rotation, I encountered an elderly patient with recurrent small bowel obstruction (SBO) who presented with abdominal distention, obstipation, and concern for possible operative management. In older adults, SBO management can be particularly challenging because clinicians must balance the risks of surgery against the risks of delaying intervention, especially in frail patients with multiple comorbidities. This article specifically evaluated how frailty and timing to …

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