A Medical H&P - Example 2

An example of an oral presentation of a medical H&P, with two levels of detail: A thorough 7-10 minute presentation that would be typical of a clerkship medical student, and a more to-the-point 3-5 minute presentation that would be typical of an experienced resident (or an intern on a busy service that doesn't have time for the "complete" H&P)

[nickgowen]

Great work Dr. Strong as always. I particularly appreciate that you are demonstrating both the longer form and the shorter form of a good presentation. While I don't disagree with anything you said about the longer form being more preferred by many internists on a slower or more time-having service, I personally always prefer the shorter 3-5 minute version. Many of my colleagues would argue that the 3-5 minute version is too difficult for junior students and that they may miss things when trying to be that brief, but I believe in pushing students to learn the skills necessary to get down to the 3-5 minute style sooner. Either way, you've demonstrated both brilliantly, and these videos will help many learners at many levels of training.

I do disagree with your fictional trainee who thinks FENa is helpful in differentiating ATN from prerenal azotemia (which I suspect reflects your own opinion), but reasonable people can disagree on that point as long as learners don't forget urinalysis. Also if a learner said "pain out of proportion" to me in any setting about either context that phrase is used (here for nec fasc or in other settings for acute mesenteric ischemia), I would push that learner to tell me what they meant by out of proportion. I'm assuming your fictional learners would have handled those questions though, so I won't judge them.

[yazinuwa]

Thank u
We really appreciate your enormous efforts to educate us ❤

[dg]

In the presentation shouldn't you note the PaO2/FiO2 to exclude sepsis induced ARDS?

[jonathandball]

Non medic here, so I apologise if this is the patient is tachycardic, wouldn't the effect of epinepherine, although helpful in elevating BP, be unwise? How would one restore a healthy relationship between heart rate and BP in this instance? Thanks.

[islamyoucef]

is there any wroten document for this presentation Dr Strong please