During my site evaluations, I presented 3 H&Ps, 10 drug cards and an article. One of the patients I presented was a elderly female presenting with dysarthria and heart palpitations lasting 15 minutes 3 days prior to being evaluated in the emergency department. Upon evaluation, she was completely asymptomatic and showed no signs of stroke. Her head CT was negative, however, the head MRI was consistent with a posterior lobe ischemic stroke. This patient was also diagnosed with paroxysmal atrial fibrillation on evaluation, which I learned most likely caused her blood clot. After presenting this case, my site evaluator was impressed with my detailed plan and expressed how I have improved from previous cases.

My article discussed how a decreased gait speed in those hospitalized with congestive heart failure, have a poorer prognosis than those without congestive heart failure. This is likely due to decreasing muscle mass in the elderly, in addition to frailty and malnutrition. I chose this article because many of my patients in St Francis Hospital were admitted with congestive heart failure exacerbations, and I was curious to know about how frailty, malnutrition, and limited ADLs impacted their morbidity and mortality.

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