Overall, this rotation was a great transition from my pediatrics rotation to OBGYN. From my NICU and Family Medicine experience, I was able to integrate everything I learned thus far and apply it to OB/GYN clinic, OB-call, and GYN-call shifts. During my time in OB/GYN clinic, I learned and gained confidence in managing common concerns such as cystocele, stress/urge incontinence, vaginitis (BV, Trichomonas, Atrophic, and Candida), genitourinary syndrome of menopause & vasomotor symptoms, abnormal pap smear results, postmenopausal bleeding, fibroids, bartholin cysts, and post-op management after hysterectomies, c-sections, myomectomies, etc… I also practiced and gained confidence in performing pelvic exams, …

For my mid-site evaluation, I presented an H&P on a peri-menopausal patient in the OB/GYN clinic who has an extensive family history of cancers, GYN Hx of fibrocystic breasts/fibroids/ovarian cysts, and was concerned about recent AUB and stress urinary incontinence. Given her FHx, age, and concerns, we discussed the most likely cause of her symptoms, which are hormonal changes due to the patient approaching menopause. Given her age and AUB, we are concerned about possible endometrial hyperplasia or carcinoma, for which a TVUS is the first-line imaging, with eventual need of endometrial biopsy if the endometrial stripe is measured >4mm. …

Article Title: Medical management of secondary postpartum haemorrhage: A prospective cohort study Authors: Rachael Fox, et al. Article Link (see pdf below): https://pubmed.ncbi.nlm.nih.gov/35699126/ The reason I chose this article is that during rotation, I saw a patient presenting to L&D triage complaining of heavy vaginal bleeding and abdominal pain about 4 weeks after an NSVD. Primary postpartum haemorrhage (PPH) occurs within 24 hours, with causes being the mnemonic as the “4 T’s”, which are Tone, Trauma, Tissue, Thrombin. Secondary PPH occurs between 24 hours and 12 weeks post-delivery, with other causes such as retained products of conception (RPOC), endometritis, and …

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Overall, this rotation served as a valuable transition from my family medicine rotation, where I previously gained experience evaluating pediatric patients in an outpatient setting. During my pediatrics rotation at QHC, my schedule consisted of 3 weeks in the pediatric emergency department, 1 week in the NICU, and 1 week in the hospital’s pediatric outpatient clinic. During my time in the pediatric ED, I felt that I had a great level of autonomy as a student. I was typically able to see and evaluate patients independently before presenting my findings and assessment to the attending physician on shift. In this …

For my mid-site evaluation, I presented a H&P on a 4-year-old pediatric patient with sickle cell disease who presented to the pediatric emergency department with a fever. Generally, in infants younger than one month of age, fever typically warrants a full septic workup. Due to this patient’s underlying sickle cell disease and prior hospitalization for splenic sequestration with fever of unknown etiology, a full sepsis evaluation was also indicated. This case allowed me to recognize the urgency and severity of febrile illness in patients with sickle cell disease and to consider potentially life-threatening complications such as bacteremia and acute chest …

Article Title: Effectiveness of Surgical versus Conservative Treatment for Distal Femoral Growth Plate Fractures: A Systematic Review Authors: Nicholas Hayes,  Kandiah Umapathysivam,  and Bruce Foster Article Link (see pdf below): https://openorthopaedicsjournal.com/VOLUME/13/PAGE/117/FULLTEXT/ The reason I chose this article is that during my pediatrics emergency department rotation, I encountered a 13-year-old male who presented with an acute right knee injury after a sports-related fall. He reported hearing an audible “pop,” had immediate pain, inability to bear weight, and limited knee flexion. On exam, there was no obvious deformity or neurovascular compromise, but imaging with X-ray and CT ultimately revealed a Salter-Harris type IV fracture of the …

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