During this rotation I participated in two site evaluations where I presented three H&P’s, a journal article, an article summary, and ten pharm cards. For the H&Ps, I chose different kinds of patients, including a Covid-19 patient, a patient with a heart failure exacerbation, and a patient with cyclic vomiting syndrome secondary to cannabis use. The three patients could not be more different, with one being an elderly male with multiple comorbidities and a lengthy hospital stay due to Covid-19, the next an exacerbation of heart failure in a very frail female of 91 years old, and the last a young female with no past medical history. I received different feedback for each H&P, including focusing on developing a detailed social history for a patient with chronic cannabis use. I also realized a lot more focus is required on detailed questions of signs and symptoms when evaluating a patient with heart failure exacerbation, as details such as changes in weight or how shoes fit could point to acute peripheral edema that was not as noticeable to the patient without posing those specific questions.

The article I presented focused on the optimal treatment for cyclic vomiting due to cannabis use as upon discussing the patient’s case with my preceptor, I learned there really is no one go-to treatment for the diagnosis as every patient responds differently and requires different medications to feel better. The pharm cards I presented were all medications that I saw regularly in patients charts. These included medications for blood pressure, urinary symptoms, pain, and nausea. I was able to learn why these were the choice medications for patients admitted for specific diagnoses, as the mechanisms of action and on-label as well as off-label indications were ideally suited to specific complaints and problems.

This entry is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International license.