Things I’ve Seen So Far in Clinicals

Hey everyone! As you can see, I’ve been really busy with rotations and shelf exams that I haven’t been updating my blog as much these past few months. Just an update, I am doing well and am in the middle of my pediatric rotation right now in Miami. My attending right now Dr. Calle has been great. The other AUC student and I directly rotate with her, and she lets us see patients on our own, present the patients to her, and gives us useful articles to read. Our schedule is usually 8am-5pm or so with an hour break in between. This week, I also started doing nursery rounds in the afternoons. After my morning shift at the Miami Beach Community Health Center from 8am-1pm with Dr. Calle, I head over to Mt. Sinai Hospital with another attending, Dr. Gonzalez, to check up on the newborn babies. We round at the nursery for another 3-4 hours. The babies are usually 0-2 days old and are just adorable. Working with these babies, I am already getting baby fever! I got to learn how to do a newborn physical examination, test reflexes, as well as see some interesting newborn conditions (often benign), like caput succedaneum, erythema toxicum, mongolian spot, nevus flammeus, etc.

Counting back to when I first started clinical rotations in January, I’ve probably seen hundreds if not thousands of patients. Most cases are pretty common conditions, but other cases you see make you realize that anything can happen in medicine, and that not everything follows the way it is in the textbook. I’ve put together a list of some of the common and not-so-common but nevertheless interesting (and often sad) conditions I’ve seen so far in my clinical rotations. It’s not complete, but here are some of the ones I can remember right now. I will update the list as I progress through clinicals.

PSYCHIATRY

• Schizophrenia — by far the most common disorder I see at the psych ward.
• Delusional Disorder
• Bipolar Disorder
• Major Depression — very common in the psych ward as well.
• Schizoaffective
• Dissociative Fugue
• Dissociative Identity Disorder (Multiple Personality Disorder)
• Conduct Disorder
• Borderline Personality Disorder
• Histrionic Personality Disorder
• Antisocial Personality Disorder
• Alcohol abuse
• Substance abuse
• Doctors who become psych patients — I guess doctors get sick too.
• Folie a deux
• Wernicke Encephalopathy
• Malingering
• Dementia

INTERNAL MEDICINE

• “Miracle” case in which a patient regains heart beat after being pronounced dead for more than 5 minutes.
• Stroke in a 20-something year old patient
• Dry gangrene from long-term diabetes
• Wet gangrene
• Decubitus ulcers
• end-stage COPD
• C. Diff from prolonged antibiotic use
• Subdural hematoma
• AIDS
• Parkinson’s Disease
• Alzheimer’s Disease
• Gastroparesis
• Attempted Suicide by overdose
• Leukocytoclastic vasculitis
• Ectopic Pregnancy
• Cholelithiasis – and yes, they are often “fat, female, forty (and sometimes fifty, as I’ve seen), and fertile” as the mnemonic goes
• Stray Dog Bite
• Hernia
• Dislocated shoulder
• Psoriasis
• Cellulitis
• Henoch-shonlein purpura (in adult)
• Sickle Cell Crisis
• Horner Syndrome from non-hodgkin lymphoma
• Apple core lesion — Colon cancer
• Large B-cell Lymphoma
• Chemotherapy-induced Cardiomyopathy
• Autoimmune cardiomyopathy
• POTS Syndrome (Postural Orthostatic Tachycardic Syndrome)
• Renal Artery Stenosis from fibromuscular dysplasia
• Sarcoidosis
• Drug-seeking behavior
• Herpes Zoster (Shingles)
• Vitiligo
• Metastatic lung cancer
• Pityriasis rubra pilaris
• Gastroenteric Cutaneous Fistula
• Gilbert Syndrome

PEDIATRICS

• Phytophotodermatitis
• Preseptal Cellulitis
• Herpangina (Coxsackie Virus A)
• Asthma
• Fragile X Syndrome
• ADHD
• Depression in child
•  Varicella — which is rare nowadays, due to the prevalence of Varicella vaccine.
• Impetigo from varicella.
• Torticollis
• Sinusitis/Otitis media
• Congenital CMV
• Polydactyly
• Congenital Adrenal Hyperplasia
• Neurofibromatosis Type I

FAMILY MEDICINE

• Patient with Progressive Multifocal Leukoencephalopathy (PML) from JC Virus
• West Nile Virus
• Rabies
• Osteomyelitis
• Duodenal Ulcer positive for H. Pylori
• Pyelonephritis
• Epilepsy
• Hepatic encephalopathy
• Delirium Tremens
• Sturge Weber Syndrome
• Fibromyalgia
• Gout
• Liver cirrhosis + Ascites

OB/GYN

• C-section
• Tubal Ligation
• Natural Delivery + episiotomy
• Uterine prolapse
• Myomectomy
• LEEP procedure
• Pregnancy with Down Syndrome fetus
• Double nuchal cord around fetal neck

ENDOCRINOLOGY

• Diabetes Type I and II
• Hypothyroidism
• Hyperthyroidism
• Hypoparathyroidism
• Osteoporosis
• VIPoma
• Amnorrhea secondary to methadone
• Hypogonadotropic hypogonadism
• Hypertrophic osteodystrophy
• Hypokalemic periodic paralysis

SURGERY

• Lipoma excision
• Laparoscopic cholecystectomy
• Laparoscopic inguinal hernia repair (with patch)
• Open umbilical hernia repair
• Perirectal abscess drainage
• Extended right hemicolectomy – they took out intestines from the ileal-cecal junction to part of the transverse colon. I helped hold back the intestines.
• Parathyroidectomy
• Open abdominal aortic aneurysm repair — 8.5 cm diameter
• Transmetatarsal amputation (modified)