As PA students we are taught a great deal of about the value of the physical exam. In addition, we spend significantly more time learning about it than most MD/DO programs.... but as with most things in PA school... too much information in too little time. It is much like drinking from a fire hose on full blast. Bates is a great resource to read, but I'm a visual learner. YouTube has tons of videos, but sometimes the hunt for a good video is tiring and often it doesn't paint the whole picture.
Luckily I came across The Stanford 25. The authors of this site came up with 25 bedside clinical evaluations that were important to them and came up with a video/text all about the subjects. Very helpful. Some videos are a little dated, but they have updated the pages with pertinent, newer videos.
All the links are on the right. Good luck.
6.21.2011
Clinical Resource Online - FREE!
I just came across this clinical book online: Clinical Methods, 3rd edition: The History, Physical, and Laboratory Examinations, Edited by H Kenneth Walker, MD, W Dallas Hall, MD, and J Willis Hurst, MD
It has lots of short, straight to the point chapters and printable charts on a ton of generalized medical topics including (but not limited to):
1. The physical exam
2. Medical interviewing
3. Cardiovascular system
4. Hematology
5. Chest Pain
6. Syncope
7. Pulse, BP, Heart Sounds
8. Wheezing, asthma
10. Sleep disturbances
11. N/V
12. Abdominal Pain
13. Jaundice
14. Neurology
15. Headaches
There are 229 Chapters so LOTS of free information!
6.19.2011
Pediatric Case Answers!
Answers from the cases in the prior post...
Pediatric Case 1: Answer = C
At 6 to 6.5 months of age, infants will be able to site along, leaning forward to support themselves with arms extended, in the so-called tripod position. They can reach for an object by changing the orientation of the torso. They can roll (on purpose) from prone to supine and visa versa. By 12 months, they can grasp a pellet between their thumb and forefinger w/out ulnar support. Motor development goes cephalo-caudal and central to peripheral - in other words, the babies can control their trunk before they can control finger dexterity.
Pediatric Case 2: Answer = D
Chlamydiae, sexually transmitted in adults, is spread to infants during birth from the genitally infected moms. The sites of infection in infants are the conjunctivae and the lungs, where chlamydiae cause inclusion conjunctivitis and afebrile pneumonia (usually in infants 2-12 wks). Diagnosis is confirmed by culture of secretions and by antibody titers. **Note: most common tx for this is macrolide antibx orally which clears both the nasopharyngeal secretions when a conjunctivitis is present and prevents the pneumonia that can occur later. Topical tx is not effective in clearing nasopharynx.
I'll try to throw out some more cases here and there... Thanks for the guesses!
Cases from PreTest Series, Pediatrics 10th Ed, Yetman and Hormann
Pediatric Case 1: Answer = C
At 6 to 6.5 months of age, infants will be able to site along, leaning forward to support themselves with arms extended, in the so-called tripod position. They can reach for an object by changing the orientation of the torso. They can roll (on purpose) from prone to supine and visa versa. By 12 months, they can grasp a pellet between their thumb and forefinger w/out ulnar support. Motor development goes cephalo-caudal and central to peripheral - in other words, the babies can control their trunk before they can control finger dexterity.
Pediatric Case 2: Answer = D
Chlamydiae, sexually transmitted in adults, is spread to infants during birth from the genitally infected moms. The sites of infection in infants are the conjunctivae and the lungs, where chlamydiae cause inclusion conjunctivitis and afebrile pneumonia (usually in infants 2-12 wks). Diagnosis is confirmed by culture of secretions and by antibody titers. **Note: most common tx for this is macrolide antibx orally which clears both the nasopharyngeal secretions when a conjunctivitis is present and prevents the pneumonia that can occur later. Topical tx is not effective in clearing nasopharynx.
I'll try to throw out some more cases here and there... Thanks for the guesses!
Cases from PreTest Series, Pediatrics 10th Ed, Yetman and Hormann
6.17.2011
Gearing Up for Clinical Rotations
Yesterday was a great day... the blog hit over 1,000 views! AND we received our rotations for the year. Nothing is written in stone (changes are possible due to preceptor maternity leaves, life changes, etc) but we now have a pretty good idea what life will be like for our last year in PA school. I couldn't be more excited... or nervous! I start out with more generalize medicine, then move into specialties, and finish up with emergency medicine and surgery. Each rotation is 5 weeks so we will finish up around mid-July 2012.
My first rotation starts in Sept and is in pediatrics at a great local practice. I used to work in pediatrics when I was in Orthotics and Prosthetics so its nice to start in a familiar setting. Kids are great, parents are difficult, and pediatric dosages are nearly impossible to remember... stay tuned - I'll share my experiences.
As of now here are my rotations:
1. Peds
2. Internal Medicine
3. Family Medicine
4. OB/GYN
5. Psychiatric
6. Ambulatory
7. Elective
8. Emergency Med
9. Surgery
In the spirit of each rotation I'll throw out a case study or two for each and then give the answer in a follow up entry. Feel free to post your guesses!
Pediatric Case 1:
An infant who sits with only minimal support, attempts to attain a toy beyond reach, and rolls over from the supine to the prone position, but does not have a pincer grasp, is at a development level of:
A. 2 months
B. 4 months
C. 6 months
D. 9 months
E. 1 year
Pediatric Case 2:
A 6 wk old child develops increased RR and a non-productive cough. Physical exam is significant for rales and rhonchi. The PMH for the child is positive for an eye discharge at 3 weeks of age, which was treated with a topical antibx. The most likely organism causing this child's condition is:
A. Neisseria gonorrhoeae
B. Staph. aureus
C. Group B streptococcus
D. Chlamydia trachomatis
E. Herpes virus
Good luck! Any words of wisdom to share?
My first rotation starts in Sept and is in pediatrics at a great local practice. I used to work in pediatrics when I was in Orthotics and Prosthetics so its nice to start in a familiar setting. Kids are great, parents are difficult, and pediatric dosages are nearly impossible to remember... stay tuned - I'll share my experiences.
 |
| This is one of my favorite pediatric practice tools! Love this kid. |
1. Peds
2. Internal Medicine
3. Family Medicine
4. OB/GYN
5. Psychiatric
6. Ambulatory
7. Elective
8. Emergency Med
9. Surgery
In the spirit of each rotation I'll throw out a case study or two for each and then give the answer in a follow up entry. Feel free to post your guesses!
Pediatric Case 1:
An infant who sits with only minimal support, attempts to attain a toy beyond reach, and rolls over from the supine to the prone position, but does not have a pincer grasp, is at a development level of:
A. 2 months
B. 4 months
C. 6 months
D. 9 months
E. 1 year
Pediatric Case 2:
A 6 wk old child develops increased RR and a non-productive cough. Physical exam is significant for rales and rhonchi. The PMH for the child is positive for an eye discharge at 3 weeks of age, which was treated with a topical antibx. The most likely organism causing this child's condition is:
A. Neisseria gonorrhoeae
B. Staph. aureus
C. Group B streptococcus
D. Chlamydia trachomatis
E. Herpes virus
Good luck! Any words of wisdom to share?
6.15.2011
Electronic STI Treatment Guideline - FREE!
The CDC has a 2010 STI Treatment book available on the iPhone/iPod/iPad. There is no fee associated with this and it is a great resource for students (or practicing PAs) trying to keep up with treatment protocols. It is not available in iTunes, so you'll have to follow the link below:
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