Suicidal Ideation

Clinic A/P, adults, Clinic A/P, Peds, PSYCHIATRY

#Suicidal Ideation 16 yo M with suicidal ideation. Not actively planning to kill self. Not homicidal. Two days ago, thought of jumping off a bridge onto a truck. -Send straight as a walk-in to Riverside County Mental Health. They will start evaluation immediately...

Recurrent UTIs in a pediatric patient

Clinic A/P, Peds

#Recurrent UTIs in a pediatric patient. The following is how a pediatrician treated an 8 year old with recurrent UTIs. 8 yo old who has had about 2 UTIs per year since preschool, mum remembers. Culture always shows E. coli and sometimes with Proteus. This patient...

How to Remove an Umbilical Cord Clamp

Clinic A/P, Peds

Recently, I wanted to remove an umbilical clamp on a 7 day old baby and the instrument broke. I searched on youtube and found this great video on how to easily remove an umbilical cord clamp using a safety pin. I didn’t have a safety pin, so we used a forceps to...

Lymphadenopathy (Enlarged Lymph Nodes) – Peds & Adults

Clinic A/P, adults, Clinic A/P, Peds

Diagnosis -H&P: Review meds for culprits. -Risk factors for cancer: -R/o palpable popliteal, iliac, and supraclavicular nodes which are always abnormal. Evaluate for palpable epitrochlear nodes greater than 5 mm which would be abnormal as well. DDx & Causes....

Congenital Hypothyroidism

Clinic A/P, Peds, Hospital A/P, Peds

-On newborn screen. -Refer to a pediatric endocrinologist. -The patient will be treated with levothyroxine for life. Titration with goal TSH WNL. “All infants with a low T4 concentration and a TSH concentration greater than 40 mU per L are considered to have...

Graves Disease

Clinic A/P, adults, Clinic A/P, Peds, ENDOCRINOLOGY

-Graves disease = the most common cause of hyperthyroidism in the United States. -Graves’ disease (thyrotoxicosis) is an autoimmune disorder in which a unique antibody called thyroid-stimulating antibody (also called TSH Receptor Antibodies) stimulates the TSH...