Med Ready

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Kanal • Broj emisija: 3

Medicina

Medicina

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Medicina

Medicina

Serija
Medicina

Medicina

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Sezona 1, epizoda 2

Labor and Delivery Triage

When a pregnant patient presents to triage, you need a systematic approach. In this episode, we cover the OB one-liner, the four essential triage questions, how to evaluate for labor and rupture of membranes, and when vaginal bleeding becomes a red flag. Show Outline: The OB One-Liner "This is a _ yr old G_ P_ @ _ wks GA here for ____." Example: This is a 34yo G3P2002 @ 38wks3days GA here for contractions Four Essential Triage Questions Contractions Leaking fluid Vaginal bleeding Fetal movement What Is Labor? – Cervical change and contractions Evaluating for ROM – Pooling, nitrazine (pH), ferning Vaginal Bleeding – In 2nd or 3rd trimester, worry about placental causes: abruption, previa, vasa previa Decreased Fetal Movement (DFM) – NSTs, BPPs, kick counts About the Speaker: Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators. Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
Sezona 1, epizoda 14

Before Your First: Colposcopy and LEEP

Abnormal Pap? This episode covers the colposcopy and LEEP procedures from start to finish – why we do them (ASCCP guidelines), the histology and staining principles behind acetic acid and Lugol's iodine, what cervical dysplasia looks like through the colposcope, and how LEEP and cold-knife cone excisions differ. Show Outline: Why – ASCCP guidelines (there's an app!) Cervical Dysplasia – Caused by HPV. CIN I → CIN III is a progression. Risk factors: smoking, other STIs including HIV, immunodeficiency. Histology – Increased nuclear-to-cytoplasmic ratio in abnormal cells Staining Principles Acetic acid: higher N:C ratio cells reflect more light and appear white (acetowhite) Lugol's iodine: reacts with glycogen in normal squamous cells (appear dark); non-staining cells are abnormal Colposcopic Findings – Increased vascularity, punctations, mosaicism, surface contour changes LEEP – Stain the abnormality, know where the abnormal biopsy was taken. Single pass is ideal – tag a side for orientation. +/- Top Hat depending on ECC result. Cold-Knife Cone (CKC) – For pathology higher in the cervical canal; more complications. No electricity – okay if pregnant. About the Speaker: Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators. Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
Sezona 1, epizoda 5

Before Your First Outpatient Newborn Visit

This episode describes how to prepare for a newborn’s first outpatient visit after they have been discharged from the birth hospital, including the information that you need to obtain from the medical record before the visit, the topics you need to discuss during the visit, and how to approach the physical examination in a newborn. Introduction Socio-emotional state of parents Before the visit, you should review Prenatal history Delivery history, gestational age Physical exam at time of birth Preventative treatments Course in newborn nursery or NICU Type of feeding Concerns for infection Bilirubin Screening tests Newborn visit Parental questions and concerns Feeding history and any problems with feeding Elimination Sleep and safe sleep Social history and parental support system Review of systems – irritability, fever, rashes. Normal newborn vital signs Infant growth parameters and weight trajectory Physical exam General Head size and shape Eyes – pupil shape, red light reflex, scleral icterus Cardiovascular – murmurs, capillary refill Respiratory Abdominal Genitourinary – testicles, hernias/hydroceles, circumcision, vaginal discharge Musculoskeletal- clavicles, hip Skin – jaundice, birthmarks, sacral dimples Neurological: tone, reflexes Anticipatory guidance Fever Safe sleep Prevention of shaken baby syndrome Postpartum depression Appropriate feeding Next follow up appointment depends on weight, bilirubin level Resources/Links: https://peditools.org/bili2022/ - resource for management of hyperbilirubinemia Links: https://peditools.org/bili2022/ About the Speaker: Host: Augustin Casals, MD – Augustin Casals, MD completed his pediatric residency at the University of Virginia. He is now a practicing pediatrician in Los Angeles, California. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.
Sezona 1, epizoda 3

Before Your First: Benign Gyn Clinic

Your first day in benign GYN clinic is fast-paced and can feel overwhelming. In this episode, we cover what to expect, what to review ahead of time, and practical tips for running an efficient, patient-centered clinic visit — even when you only have 15 minutes. Topics Covered: What to Expect on Your First Day – A mix of new patients, annuals, return visits, and problem-based appointments. Common complaints include contraception, AUB, pelvic pain, abnormal discharge, STI testing, and post-op checks. Expect a fast pace and feeling slow at first. What to Review Ahead of Time Well woman visit guidelines AUB basics (PALM-COEIN) and the initial workup ASCCP guidelines (brief overview) Contraceptive options and the Medical Eligibility Criteria app Vaginal discharge workup — STI testing, wet prep Tips for a Smooth, Efficient Clinic Pre-chart! Check for recent ED visits, PCP discussions, last pap, imaging, STI results. Document as you go — brief notes while talking, make them complete later. Optimize your EMR — templates that make sense, favorite order sets. Make eye contact. Biggest Challenges and How to Overcome Them Efficiency: Practice-focused HPIs. Sensitive conversations: Sexual history, IPV screening, menses — be direct and compassionate. Pelvic exam confidence: Be trauma-informed, narrate what you're doing, be quick and confident. Don't tell patients to expect pain. Saying "I don't know": Explain your thinking, discuss with the attending, and come back. Advice We Wish We'd Known – Your confidence in pelvic exams improves dramatically. Give it time. About the Speakers: Host: Lucy Brown, MD, MPH – Resident physician at Johns Hopkins GYN/OB. Dr. Brown is passionate about medical and resident education and will be pursuing a Fellowship in Complex Family Planning after residency. Guest Speaker: Adrianna Gorniak, MD – Gyn/Ob resident at Johns Hopkins Hospital in Baltimore, MD. She has a passion for all things gynecology, with a special interest in complex benign gynecology. Intern Ready: Ob/Gyn is a podcast aimed at interns and off-service residents beginning their post-graduate training in Obstetrics and Gynecology. The views expressed are the speakers' own and do not constitute medical advice.
Sezona 1, epizoda 4

Peds GI Clinic

In Pediatric Gastroenterology (or GI) clinic, you will see patients with a host of gastrointestinal, pancreatic, liver, and nutrition issues. This episode will discuss specific questions that you will want to cover in your history and the elements of a complete GI exam - which is a lot more than just an abdominal exam! Peds GI clinic covers a host of gastrointestinal, pancreatic, liver and nutrition issues -3yr fellowship after peds residency Before Clinic Review what types of patients you will be seeing. It may be a mix of lots of issues, or just a liver transplant clinic. This will tell you what type of prep you should do (conditions to read up on, medications to review, etc) before the day of clinic. On the day of clinic, review expectations with the attending, fellow or resident physician. Do they want you to see patient independently and write notes, just shadow or somewhere inbetween. Review what questions they always want asked, what exams you should do alone vs with your whole team. Setting expectations before you start will set you up for success! Questions: Pain, the PQRST mnemonic is helpful to better understand the pain Provoked the pain Quality of the pain Radiating Severity Specific questions to ask in Peds GI: Does pain wakes the patient at night? how much school or other activities the Patient has missed because of symptoms? Does defecation or passage of gas alleviates pain? Any specific dietary changes already tried? Poop! understand the: Quality of the stool Size and caliber of the bowel movement (Use Bristol stool scale) GERD vs EoE A complete GI exam– a lot more than the abdomen! About the Speakers: Host: Rachel Moon, MD – Rachel Moon, MD is the Harrison Distinguished Professor of Pediatrics at UVA Health Children's. She is an internationally recognized researcher in sudden unexpected infant death and chairs the AAP Task Force on SIDS. She is also the Chief of General Pediatrics at UVA. Host: Jeremy Middleton, MD – Jeremy Middleton, MD is an Associate Professor of Pediatrics and Pediatric Gastroenterologist at UVA Health. He serves as the Pediatrics Clerkship Director and has expertise in children with intestinal failure and aerodigestive disorders. Host: Shakun Gupta, MD – Shakun Gupta, MD is an Associate Professor of Pediatrics and Associate Clerkship Director at the University of Virginia. She completed her residency at Lurie Children's Hospital/Northwestern and joined UVA in 2014, where she practices general pediatrics and pediatric hospital medicine. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.
Sezona 1, epizoda 10

Before You Get a Sexual History

The sexual history is an important part of the adolescent visit. In this episode, we will discuss the importance of the sexual history and how to handle patient confidentiality. We will introduce the 5Ps framework for the sexual history. We will also brieflyy discuss screening for sexually transmitted infections (STIs), including human immunodeficiency virus (HIV). Sexual History - why it is important Confidentiality 5 Ps Framework Partners Practices Protection of STIs Past history of STIs Pregnancy Intention STI Screening and Treatment HIV screening algorithm References: 5 Ps Framework: https://www.cdc.gov/std/treatment/SexualHistory.htm STI Screening and Treatment: https://www.cdc.gov/std/treatment-guidelines/provider-resources.htm#MobileApp https://www.cdc.gov/std/treatment-guidelines/default.htm HIV screening algorithm: https://stacks.cdc.gov/view/cdc/50872 Links: https://www.cdc.gov/std/treatment/SexualHistory.htm https://www.cdc.gov/std/treatment-guidelines/provider-resources.htm#MobileApp https://www.cdc.gov/std/treatment-guidelines/default.htm https://stacks.cdc.gov/view/cdc/50872 About the Speaker: Host: Jennifer Louis-Jacques, MD, MPH – Jennifer Louis-Jacques, MD, MPH is an Associate Professor of Pediatrics specializing in Adolescent Medicine at UVA Health. She trained at Columbia/NYU and completed her fellowship at Boston Children's Hospital, with special interests in eating disorders and menstrual disorders. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expressed are the speakers' own and do not constitute medical advice.
Sezona 1, epizoda 10

Shoulder dystocia

Shoulder dystocia is an unpredictable obstetric emergency where seconds matter. This episode covers the definition, risk factors, prevention counseling, exactly what you'll see in the delivery room, and how you as a student can be most useful – including timekeeping and supporting the family. Show Outline: Definition – Failure to deliver fetal shoulders with normal downward traction Why We Care – Baby hypoxia, brachial plexus injuries, maternal injuries Risk Factors – Diabetes, excessive weight gain, S>D, large baby, history of shoulder dystocia (~10–15% recurrence), turtling while pushing Prevention – Difficult to predict. Offer cesarean if EFW >5000g (no DM) or >4500g (with DM). Your Role – Step back. Help minimize family interference with calm explanations. Offer to be the timekeeper – write down times and events, announce every 2 minutes. What You'll See Hypothesize shoulder orientation, suprapubic pressure, place stool Announce the problem and call for help Maneuvers: McRoberts, suprapubic pressure, posterior arm delivery, rotational (Wood's screw, Rubin), Gaskin's (all fours), episiotomy, Zavanelli (last resort) About the Speaker: Jennifer Doorey, MD, MS – Academic Ob/Gyn at The Johns Hopkins University School of Medicine. As the founder of MedReady, Dr. Doorey seeks to advance clinical medical education by developing resources for medical students and clinical educators. Procedure Ready: Ob/Gyn is a podcast aimed at medical, PA, and NP students entering their clinical rotation in Ob/Gyn. The views expressed are the speaker's own and do not constitute medical advice.
Sezona 1, epizoda 1

Your Pediatrics Survival Guide - Tips and Tricks

Pediatrics is different from any other rotation that you will do. Children are not just small adults. There is a huge range of ages and developmental stages. This episode will provide you with some general tips and tricks for all clerkships in general and the Pediatrics clerkship specifically, and essential resources that will help you to succeed in your clerkship. Essential Resources Podcasts: Clerkship Ready-Pediatrics Charting Pediatrics - Weekly podcast with lots of bread-and-butter pediatrics discussed. Pediatrics on Call - The most recent research and the newest policy updates from the American Academy of Pediatrics. Books: Red Book (also an app for AAP members) - the definitive source for pediatric infectious diseases. Harriet Lane Handbook (also an app) - has drug doses, commonly used charts, and algorithms. Websites: Peditools for bilirubin Uptodate CDC website is a great source for vaccine guidelines Apps: PedsScripts App: specifically to work on illness scripts General Tips and Tricks: Be Proactive Know what the expectations are. Become familiar with the electronic medical record system. Be Self-sufficient, but ask for help when appropriate. Know when you should come in to round, who to pre-round on, and where to meet. Pair up with an intern to pre-round. Ask for feedback. Pediatric-specific Tips and Tricks: Pediatrics is different from any other rotation. Huge range of ages and developmental stages. At every age, children act differently - and you need to adjust appropriately. If you can, get as much of the history from the child, but you will likely need to supplement that with history from the parent or guardian. When you do your physical exam on younger children, have to adjust the order of exam Vital signs change with age. Look up or ask about what is a normal vital sign in the age you are seeing. Check weight, length/height and/or head circumference and report both percentiles and trends. If an infant has been born prematurely, correct growth and development for gestational age. Fluids and medication are dosed per kilogram. Family-centered rounds are a unique, important part of pediatrics. The goal is to get both the team and family up to date on the patient’s diagnosis and overall course, and to formulate a plan for the day together with the family. Brief summary and plan outside of the patient room. Invite family to participate. Conversational language with no medical jargon. Be concise and clear. About the Speakers: Host: Rachel Moon, MD – Rachel Moon, MD is the Harrison Distinguished Professor of Pediatrics at UVA Health Children's. She is an internationally recognized researcher in sudden unexpected infant death and chairs the AAP Task Force on SIDS. She is also the Chief of General Pediatrics at UVA. Host: Jeremy Middleton, MD – Jeremy Middleton, MD is an Associate Professor of Pediatrics and Pediatric Gastroenterologist at UVA Health. He serves as the Pediatrics Clerkship Director and has expertise in children with intestinal failure and aerodigestive disorders. Host: Shakun Gupta, MD – Shakun Gupta, MD is an Associate Professor of Pediatrics and Associate Clerkship Director at the University of Virginia. She completed her residency at Lurie Children's Hospital/Northwestern and joined UVA in 2014, where she practices general pediatrics and pediatric hospital medicine. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their c...
Sezona 1, epizoda 26

Before You See a Child Who Has Ear Pain

Ear pain is one of the most common chief complaints pediatricians encounter in the outpatient setting and there are quite a few things you need to consider to make a thoughtful diagnosis, assessment, and plan. In this episode, we will discuss the differential diagnosis of ear pain in children, physical exam findings that will help you make a diagnosis, and treatment for the most common causes of ear pain. Ear anatomy Outer ear, tympanic membrane (TM), middle ear, inner ear Eustacian tube in children is smaller in diameter and angled more horizontally than in adults. This makes it more difficult to drain fluid behind the middle ear and why kids are more prone to get ear infections when they get a cold than adults are. The adenoids also are thought to play a role in fluid collection and buildup. Taking a history for patient with chief complaint of ear pain How old is this child? Have they had a fever? Are there any other viral symptoms such as cough, runny nose, or sore throat? Has the child been swimming recently? Has the child put anything in their ears? Has there been any ear drainage or changes in hearing? Ear examination Make sure that the child’s head is as still as possible How to use the otoscope What to look for: Color of the TM. Fluid behind the TM Is the TM bulging or not bulging Light reflex of the TM Ear canal Acute otitis media Infectious causes - bacteria (especially Strep pneumonia, H influenzae, and Moraxella catarrhalis), viruses Treatment Antibiotics vs. “watch and wait approach” Criteria for using antibiotics Antibiotic options Indications for tympanostomy tubes Acute otitis externa (“Swimmer’s ear”) Causes Clinical presentation Treatment Foreign body in ear Mastoiditis Resources and Links: Anatomy and Ear Tubes/Adenoidectomy https://www.texaschildrens.org/departments/ear-nose-and-throat-otolaryngology/conditions-we-treat/dysfunction-eustachian-tube#:~:text=Eustachian%20tubes%20in%20children%20are,cause%20pain%20for%20the%20child. https://www.childrensmn.org/educationmaterials/childrensmn/article/18784/adenoidectomy-and-ear-tubes/#:~:text=The%20adenoid%20is%20located%20next,is%20for%20recurrent%20nasal%20infections https://www.ncbi.nlm.nih.gov/books/NBK570549/#:~:text=The%20middle%20ear%20consists%20of,the%20transmission%20of%20sound%20waves. https://www.ncbi.nlm.nih.gov/books/NBK551658/#:~:t...
Sezona 1, epizoda 8

Before You Counsel on Vaccines

Providing vaccines is one of the most important health promotion activities that we do. However, it involves much more than just putting in the orders for the various vaccines. In this podcast episode, we will briefly review how vaccines work, the types of vaccines, what you need to do before the visit, what you should review with families before ordering the vaccines (including precautions and contraindications), and anticipatory guidance about vaccines. We will also talk a little bit about how to handle vaccine hesitancy. List of pediatric vaccines How vaccines work Harmless piece of the pathogen that is enough to create immune response Explaining how vaccines work to parents Emphasis on protecting the community, not just one person Analogy of vaccine being like a software update Analogy of vaccine being like a flame retardant that stops a fire from spreading Analogy of vaccine being like an insecticide that stops bugs from spreading Types of vaccines Live, attenuated vaccines – cannot be given to patients with immunocompromise Vaccines without live, attenuated pathogen – includes mRNA vaccines RSV vaccines Vaccine for older adults and pregnant adults Monoclonal antibody for infants What you need to do before the visit Review the vaccine record Review the medical record for vaccine contraindications What you should review with families before ordering the vaccines (including precautions and contraindications) Current or recent illness Allergies Problems with vaccines in the past Chronic disease History of intussusception, seizures, neurological problems History of blood transfusion, immunoglobulin or antiviral medications Pregnancy Anticipatory guidance about vaccines Shared decision making Common side effects are a sign that vaccines are working Treatment of fever How to handle vaccine hesitancy Recommend the vaccines Ask if they have questions that you can answer Provide reputable resources Helping older children with their anxiety about being vaccinated REFERENCES/LINKS: www.cdc.gov/vaccines AAP Child and Adolescent Immunization Schedule by Age: https://publications.aap.org/redbook/pages/Immunization-Schedules?autologincheck=redirected O’Shea P, John J, et al. Reframing the Conversation about Child and Adolescent Vaccines, January 2023, Frameworks Institute. https://www.frameworksinstitute.org/wp-content/uploads/2023/01/reframing-the-conversation-about-child-and-adolescent-vaccinations_Jan272023.pdf Links: http://www.cdc.gov/vaccines https://publications.aap.org/redbook/pages/Immunization-Schedules?autologincheck=redirected https://www.frameworksinstitute.org/wp-content/uploads/2023/01/reframing-the-conversation-about-child-and-adolescent-vaccinations_Jan272023.pdf About the Speaker: Host: Rachel Moon, MD – Rachel Moon, MD is the Harrison Distinguished Professor of Pediatrics at UVA Health Children's. She is an internationally recognized researcher in sudden unexpected infant death and chairs the AAP Task Force on SIDS. She is also the Chief of General Pediatrics at UVA. Clerkship Ready: Pediatrics is a podcast aimed at medical students doing their clinical clerkship in Pediatrics. The views expresse...

Med Ready aims to advance clinical medical education by developing accessible resources for medical students and clinical educators. Our projects include the Pimped app, Procedure Ready: Ob/Gyn (a top 10 medical student podcast), and our new podcast, Clerkship Ready: Pediatrics.

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Med Ready

Najpopularnije emisije

Labor and Delivery Triage

Before Your First: Colposcopy and LEEP

Before Your First Outpatient Newborn Visit

Before Your First: Benign Gyn Clinic

Peds GI Clinic

Before You Get a Sexual History

Shoulder dystocia

Your Pediatrics Survival Guide - Tips and Tricks

Before You See a Child Who Has Ear Pain

Before You Counsel on Vaccines

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