Happy Holidays from SAACOFP - December 2009 Student Association e-Newsletter

Team Up With Your Faculty Advisor
By Harry J. Morris, DO, MPH
Advisor to the National Student Executive Board

The faculty advisor is a resource to help you enhance the effectiveness of your SAACOFP chapter. Here are some tips to keep in mind when interacting with your advisor:

• Physicians are very busy professionals and may appear unapproachable. However, they have a sincere interest in students and will find time to help you with the chapter.
• Make time to personally meet with your advisor when he/she is available. Email the advisor and ask to meet in their office at a time convenient to them. If the advisor doesn’t use email, or if they are slow to respond to email, call their office and speak either with the advisor or the office manager to set an appointment for a time convenient for the advisor.
• When you meet with the advisor, bring two or three chapter officers and share your enthusiasm and vision for the chapter.
• Explain your plans and activities for the upcoming months and then ask for advice from the advisor. Always have some flexibility in your version of the plan and be prepared to accept suggestions from the advisor. Many times the advisor has been involved with the chapter for years and may have experience which can help you avoid unforeseen pitfalls.
• Ask your advisor to speak at a chapter meeting on a topic of their choice. If you want the advisor to speak on a specific topic and they are hesitant, ask them for other faculty resources on and off campus for that topic. Then, ask the advisor to pick another topic on which to speak.
• Tap into the connections that your advisor has on and off campus for lectures, workshops, and activities. Many advisors know residency directors, physicians in practice, and medical leaders in your state who would be available to you with a little help from the advisor.
• Keep your advisor well informed and up-to-date on chapter activities. If problems arise, ask for advice early and often. The advisor can mediate issues and defuse tension before things escalate.
• Invite the advisor to all activities in advance. That allows the advisor’s schedule to be kept open for chapter meetings.
  Keep in mind that advisors draw on your energy and enthusiasm. Great chapters result when chapter officers involve the faculty advisor and translate their ideas into a great program.

By Lynn Wilson

Did you know that the month of December is not only a time of celebration for many holiday traditions, but also National Drunk and Drugged Driving Prevention Month? According to the National Highway Traffic Safety Administration, about three in every ten Americans will be involved in an alcohol-related crash at some point in their lives. As future physicians, we will come in contact with someone whose life has been forever changed by drugged or drunk driving. During this holiday season, I encourage each of you to take this opportunity to educate your family, friends, patients and colleges about the importance of this issue.

For more information, fact sheets and research on this and other topics, see the Centers for Disease Control Website at http://www.cdc.gov.

		GA-PCOM Angel Tree

The Philadelphia College of Osteopathic Medicine at Georgia is the highlighted chapter for the month of December. SAACOFP Student Chapter President Kevin Ward, convinced the Salvation Army to erect an Angel Tree on the GA-PCOM campus. Each ornament contained the name of either a young child or elder adult and some items that the individual needed (ex. Shirt, shoes) and one item that he/she wanted (ex. Perfume, etc.).Students took the ornaments and purchased the items listed, then returned them to a booth set up by the GA-PCOM SAACOFP chapter at the school. The gifts were then sent to the Salvation Army distribution center in Atlanta. The project was a success - the ornaments were put on the Christmas tree November 15 at 9:00 pm and within 48 hours every single ornament had been taken by a GA-PCOM student or faculty member. What a great community outreach program! Keep up the great work GA-PCOM.

Step 1:
A 2 year old boy is seen by his family physician due to failure to thrive and frequent diarrhea. The mother says his stools are pale, bulky, and foul smelling. Sweat chloride concentrations are elevated. Which pancreatic product is diminished leading to the boy’s apparent fat malabsorption?

1. Lipase
2. Proclipase
3. Peptide
4. CCK
5. Bicarbonate

Step 2:
A 46-year old African-American female s/p cath is under your care awaiting mitral valve replacement. She presented to the ED 5 days ago complaining of shortness of breath. She stated that in the past she was occasionally short of breath when she exercised, but lately it was happening at rest. She had an unproductive cough and felt fatigued; she denied hemoptysis, fever, chest pain, dizziness, N/V/D/C. PMH is significant for HTN, which is well-controlled with meds; she has had no surgeries. FHx is significant for HTN and CAD. The pt denies tobacco, ETOH, and illicit drug use; she works as a 3rd grade teacher and is married with one daughter. Meds: Lisinopril 12.5mg PO qd, HCTZ 25mg PO qd. All: NKDA. On physical exam, the pt is a well-nourished, well-dressed G1P1 African-American female in mild distress. T98.7, P121, R20, BP 115/70, O2 92% ORA. The physical exam was benign except for a holosystolic murmur heard best at the apex of the heart. EKG was normal. XR showed a LLL infiltrate and cardiomegaly. Blood cultures are pending. The patient was admitted to the hospital and placed on levofloxacin (LEVAQUIN) 750mg IV q24h. Cardiac catheterization was performed the day of admission - coronary arteries were clear but >1/3 of the mitral valve was seen to be prolapsing. The leaflets were without vegetations or calcification. Currently, the pt has been declared stable by Cards and is scheduled for mitral valve replacement this afternoon. When you see your patient before rounds today, she states she has no complaints and she is feeling great. When you review her chart, her Tmax is 101.6. What is the next best step in management of this patient?

1. Continue current pharmacologic treatments and prep the pt for mitral valve replacement surgery this afternoon.
2. Continue current pharmacologic treatments and instruct the nurses to administer Tylenol 500mg when the pt has an elevated temp. Prep the pt for mitral valve replacement surgery this afternoon.
3. Modify the antibiotic therapy by adding imipenem 0.5gm IV q6h and prep the pt for mitral valve replacement surgery this afternoon.
4. Modify the antibiotic therapy by adding imipenem 0.5gm IV q6h and postpone the mitral valve replacement surgery.
5. Discontinue levofloxacin and put the pt on Ceftriaxone 1gm IV q24h and postpone the mitral valve replacement surgery.
   

St Joseph Health Center
Program #: 126203
Warren, OH 44484
Location: Urban
 
James A. Rider, DO, Resident Recruiter
611 Eastland Ave SE
Warren, OH 44484-4582
Phone: (330) 841-4643
 
Q: Why do you recommend your osteopathic residency program to prospective medical students?
A: The role of our program is to provide the resident organized progressive, primary responsibility for the care of patients in a family environment. This is accomplished through didactic and clinical experiences under the supervision of attending family practitioners and in cooperation with allied specialists. Emphasis is placed on the longitudinal approach and the educational aspects in the care of ambulatory patients, as well as geriatric medicine. There is good support from attending while maintaining resident autonomy. Our FP clinic has lots of opportunity for procedures and OMT.

Q: What advice do you give to prospective medical students trying to choose the best residency program for themselves?
A: Before you choose, look at the call schedule and house nights, talk to the current residents to find out if you are compatible and talk to the program director to see what their intended learning style is like.

Q: Any other information you would like to pass on to prospective residents for your program?
A: The resident program offers these additional benefits:

• Pays your AOA/OOA dues
• $250 gas allowance for required education travel
• training license initial fee and annual renewal fee
• 2 lab coats per year; meals ($10.50 per day/$220 per month)
• Intern/Resident exercise facility and Simulation Lab

Answers to December e-Newsletter Prep Kwon DO Steps 1 & 2.
Step 1 Answer: A
This patient suffers from cystic fibrosis. Cystic fibrosis is a genetic disorder, where there is a mutation in the CTFR chloride channel. Patients with cystic fibrosis have an inability to secrete bicarbonate and water, therefore the pancreatic enzyme lipase cannot adequately reach the intestinal lumen. This results in fat malabsorption resulting in pale, bulky, foul smelling stools. 

Step 2 Answer: D
Modify the antibiotic therapy by adding imipenem 0.5gm IV q6h and postpone the mitral valve replacement surgery. The patient’s current antibiotic therapy is failing because she had a temperature of 101.6 overnight. You must add an antibiotic to increase coverage (see the Sanford Guide to Antimicrobial Therapy for current recommendations). You must postpone the patient’s MVR surgery because cutting into her pericardium may seed infection to her heart from elsewhere in her body.