11 articles JCMC / HV

Autosomal Dominant Polycystic Kidney Disease

Autosomal Dominance Polycystic Kidney Disease: Bilateral firm flank masses HTN Hematuria, proteinuria, renal insufficiency Other extra-renal complications: Intracranial aneurysm (Circle of Willis) Intracerebral or Subarahnoid hemorrhage Higher risk in patients with FHx of ruptured aneurysm. “Thunderclap” sudden onset severe headache, nausea, vomiting, neck stiffness, low-grade fever, uncontrolled HTN, lethargic CT head to diagnose (may miss…

EPIC – ETSU Discharge Summary Template

ETSU Discharge Summary Template Patient Name: MRN: Admission Date: Discharge Date: Attending on Discharge: Primary Care Physician: Consulations: include name & specialty Primary Discharge Diagnosis: Most pertinent dx for admission Secondary Diagnoses: Ancillary dx in addition to primary Must include all diagnoses treated during hospital course Don’t forget chronic illnesses addressed during admission Procedures: Include…

EPIC – ETSU Progress Note

ETSU Progress Note Overnight events and interval history: Medication Data: Antibiotics including #days and stop date if known IVF/Drips Scheduled meds PRN meds Physical Exam: Vitals: General: HEENT: Cardio: Resp: GI: Ext: Derm: Neuro: Psych: Diagnostics: Labs Micro Imaging EKG: Assessment: List of active diagnoses addressed during today’s visit Optional to include chronic/resolved diagnoses IF…

EPIC – ETSU H&P

ETSU H&P Patient Name: MRN: Date of Admission: Date therapy started Attending Physician: PCP: Chief Complaint: Primary issue that brought patient to the hospital HPI: (history of present illness) Must include 4 out of 8 medicare elements: location, quality, severity, duration, timing, context, modifying factors, associated signs & symptoms Don’t forget pertinent positives and negatives…

Case Management, Social work

Social/financial issues: Every floor has a case manager. They can be a valuable resource and are responsible for many patient issues including: setting the patient up if they are going to a rehab facility after discharge. insurance issues price/cost of medications and if patient qualifies for discounts/coupons Barriers to discharge: You may have to track…

Random tips: What to do at night, floor pager, critical labs, etc.

General medicine ward scenarios/tips: The following are just a few scenarios that you will likely find yourself in at some point in your intern year. At first, you should inform your senior for almost every patient related page that you receive. Your senior is asleep/unavailable, and you get a page from the nurse that a…

Discharging: medications, diet, etc.

Medication reconciliation: this is perhaps the single most important part of the patients discharge, and probably their entire hospitalization. Again, your senior will go over this with you on every patient discharge. -Diabetes medications. These can be tricky. Often we will place patients on a subcutaneous insulin regimen while they are inpatient. If they have…