During my site evaluations, I presented 2 H&Ps, 10 drug cards and an article. One of the patients I presented was a 17 year old female presenting with left sided severe headache for a week. Upon evaluation, she had left ptosis with excessive tearing. Her extraocular movements were intact and the rest of her physical exam was normal. Her head CT and MRI was negative, and was diagnosed with cluster headache. After presenting this case, my site evaluator was impressed with my detailed plan and expressed how I could improve in developing a more detailed cranial nerve exam.

My article discussed cognitive and motor outcomes of children with prenatal opioid exposure. Children ages 6 months – 18 years were included in the study and it was concluded that POE has a negative association with cognitive and motor outcomes. I chose this article because I helped treat a patient in the NICU who was showing symptoms and signs of drug withdrawal, and wanted to research more about the condition. Upon testing this 0 day old infant, his drug panel came back positive for opioids, methadone, and cocaine, and was eventually treated with medications to help his withdrawal symptoms.

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