Author: Ariel Niazov
Journal Entry
Olanzapine-Samidorphan for Schizophrenia: A Systematic Review and Meta-Analysis Schizophrenia and bipolar disorder are serious mental health conditions that affect how people think, feel, and behave on the daily basis. Schizophrenia involves patients who have auditory/visual hallucinations, delusions, and disorganized thoughts and behaviors. Bipolar disorder sees patients with extreme mood swings that can include emotional highs (like in a manic phase) and lows (depression). Olanzapine is a second-generation atypical antipsychotic medication that works on the 5HT2A receptor, that aids in helping patients with schizophrenia and bipolar disorder. One of the main drawbacks to long-term Olanzapine use is that it gives rise …
History & Physical
CC – As per patient’s husband patient was having “Aggressive and threatening behavior” X 2 hours ago HPI – 26 y/o female with history of psychosis who was brought in by EMS activated by her husband for agitation and erratic behavior. Both husband and patient have not been living in the same apartment for the past month because husband stated he needed space from his wife. Today patient’s husband came to their apartment along with patient’s father and saw the patient with another unidentified man in their living room. The husband noticed a baggy with some kind of white substance …
Emergency Medicine – PICO #3
Brief description of patient problem/setting (summarize the case very briefly) Working in the main ER, you notice a patient getting triaged that has shortness of breath, fever, chills and fatigue. They tested negative for COVID/Flu and you are suspecting pneumonia. Standard of practice is getting a chest x-ray to confirm the diagnosis, but you have seen FAST exams being done for fluid accumulation in the chest and abdomen, and wonder if POC ultrasound can be used to look for consolidations like pneumonia in an acute situation. Search Question: Clearly state the question (including outcomes or criteria to be tracked) In …
Emergency Medicine – PICO #2
Brief description of patient problem/setting (summarize the case very briefly) As you come into the emergency room for your shift, the other PA gives you the sign off on a patient that came in with diabetic ketoacidosis. You notice the bag of intravenous insulin that is helping offset the DKA, and you wonder if insulin given subcutaneously would also help the patient without possibly having them become hypoglycemic. Search Question: Clearly state the question (including outcomes or criteria to be tracked) In patients with diabetic ketoacidosis, how does subcutaneous insulin versus intravenous insulin affect the time to DKA resolution and …
Emergency Medicine – PICO #1
Brief description of patient problem/setting (summarize the case very briefly) While viewing a patient come into the emergency department for a cardiac arrest, you investigate different modalities that can used to extend neurological outcomes and survival rates of affected patients before they hit the ambulance doors of the ED. One of the longer standing attending physicians talks about cooling techniques that can possibly be utilized. Search Question: Clearly state the question (including outcomes or criteria to be tracked) In adults with out-of-hospital cardiac arrest, does prehospital therapeutic hypothermia compared to standard care without prehospital hypothermia improve neurological outcomes and survival …
Reflecting on the Rotation
My emergency medicine rotation consisted of being in an emergency room doing 12-hour shifts three days a week for five weeks. Some of the shifts were during the day (7a-7p) and others were overnight (1p-1a), and most weeks I worked on a weekend day. I really enjoyed my five weeks working in the emergency room. I saw many different patients with a myriad of different pathologies and ailments. I saw close to a dozen patients every day. The emergency room consisted of two separate triaging areas. One of the areas called Fast Track consisted of lower acuity patients with muscle …
Site Evaluation Summary
For my site evaluations, I did three History and Physicals on several different patients. The first patient I wrote about had facial drooping for a couple of days. The first must-not miss diagnosis you must have on your differentials must be CVA, but this patient did not present with any of those signs or symptoms. The second patient had an acute abdomen with abdominal pain, emesis, and diarrhea for four days. The differential list of those are pages long, but with a good history/PE and imaging, we found that she had colitis. The third patient was a young woman who …
Typhon Posting
Journal Entry
Hematuria: Is it useful in predicting renal or ureteral stones in patient presenting to emergency department with flank pain? As I have spent several weeks at the emergency room, I have noticed many patients who came in with kidney stones, and one of the main imaging modalities that were used was a non-contrast CT scan. I wanted to look closer to see if any updates were available in new imaging modalities or other lab tests that could be done to find out if someone has a kidney stone without subjecting them to radiation. I found a study that aimed to …
