This rotation I participated in two site evaluations. During the first evaluation, I presented a history and physical on a patient with a rash that was diagnosed as intertrigo with candida infection. This was an interesting case to write up and present as skin findings has such vast differentials and everything from contact dermatitis to insect bites and cellulitis must be considered until ruled out. I also presented five medications that I saw prescribed commonly in the family medicine office. These included statins, antihypertensives, and thyroid hormone replacement.

 

For the second site evaluation I presented a history and physical on a patient with lower chest and mid-back pain. I chose this case as this was a 39-year-old female who although was diagnosed with GERD, had to be worked up for an atypical angina presentation that could’ve been mistaken for GERD. I received helpful feedback regarding adding even more differential diagnoses than the most probable ones I chose, as chest and abdominal pain have such wide differentials. I presented five medications, including medications for treatment of diabetes, neuropathy, overactive bladder, and hypertension. I was pleasantly surprised to learn from my site evaluator that metformin, a medication that is regarded as a safe and widely prescribed drug, can be the cause of overdose leading to severe metabolic acidosis. I also presented an article regarding safety and efficacy of CGRP antagonists for migraine treatment, as I have seen plenty of these medications being prescribed over the past few weeks.