Browsing by Author "Thompson, Jordan"
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Item Discussion on Treating Pyelonephritis and Borderline Sepsis on Medical Mission Trips(2024-03-21) Thompson, Jordan; Garcia, Bianca; Hadley, LescaDiscussion on Treating Pyelonephritis and Borderline Sepsis on Medical Mission Trips Bianca Garcia OMS-II, Jordan Thompson OMS-III, Lesca Hadley, MD The Texas College of Osteopathic Medicine, UNT Health Science Center, Fort Worth, TX; Antigua, Guatemala Medical Mission Introduction: The case report discusses the diagnosis and management of pyelonephritis while on a DOCARE medical mission trip in Guatemala. Pyelonephritis is a common and very treatable diagnosis in the United States due to easy access to resources and physicians. This case is unique because it discusses the specific challenges providers faced not only managing but diagnosing the disease due to limited resources and lack of follow up care. The goal of this case report is to demonstrate the unique obstacles providers faced while working on a medical mission trip. Case Summary The patient was a 27 yo female who presented to the clinic with nonspecific complaints of pelvic pain and 3 days of dysuria, polyuria and thick/yellow discharge. Upon arrival at the clinic, the patient had a BP of 115/70, pulse 91 and a temperature of 100.7. Urinalysis demonstrated moderate leukocytes and negative pregnancy test. Physical exam demonstrated negative CVA tenderness. The differential for the patient remained UTI vs pyelonephritis. The patient’s temperature and pulse met 2/4 SIRS criteria which was concerning for a more serious infection such as pyelonephritis. However, the lack of CVA pointed more towards UTI. Making a treatment planned posed challenges because without a leukocyte count or blood cultures there was no way to confirm pyelonephritis. Providers knew that it was unlikely for the patient to receive follow-up care if the infection were to progress. Due to this, it was elected to choose a more aggressive treatment for pyelonephritis with 500mg ciprofloxacin BID for 14 days and instructions to find a hospital if symptoms worsen. Conclusions In the village of the DOCARE clinic, only 10% of the village has access to health care. The closest public clinic is 1.5 hours away and hospital is 2 hours away. Based on literature review, the standard of care for pyelonephritis would include of larger workup with blood cultures to guide antibiotic choice and close monitoring and follow-up of the patient. This standard of care was not available in Guatemala. Understanding of the resources available to the patient was a key factor in choosing a more aggressive treatment for the patient.Item Near Peer Ultrasound Education Evaluation(2023) Wyszynski, Katy; Thompson, Jordan; Young, Katherine; Vasilev, Viktor; Weeks, Cassidy; Weindruch, Louisa; Gibson, JohnUltrasound training is incorporated throughout the medical curriculum at Texas College of Osteopathic Medicine (TCOM) beginning in the Year 1 Physical Exam Course where students are introduced to the fundamental of Ultrasound as it pertains to each organ system being taught. In Year 2, the training is included in the Simulation Lab curriculum. In the past 4 years, ultrasound education at TCOM has become more formalized with the use of second year students as ultrasound teaching assistants. The purpose of our study is to examine the effectiveness of near peer teaching in the setting of ultrasound. Near peer teaching occurs when material is taught to students by their peers, and this has been proven to be an effective teaching technique in other settings. We hypothesized that medical students prefer near peer teaching to learn ultrasound, and that student teaching assistants will facilitate a better learning environment. Medical students from the classes of 2022, 2023, 2024 and 2025 were surveyed about the effectiveness of near peer education. Results were initially published at RAD 2021, however in the past 2 years the Ultrasound teaching assistant program has expanded and become more formalized. 138 medical students completed the survey, and 78% of students responded that they learn effectively during ultrasound taught near peer sessions. 67% of medical students indicated that they prefer near peer teaching to another teaching style. In addition, the teaching assistants from the TCOM classes of 2022, 2023, 2024 and 2025 were surveyed with 33 responses. 100% of the teaching assistants surveyed indicated that through the use of near peer education, being a TA enhanced their medical education. Our results across multiple years of medical students demonstrate the utility of near peer teaching and that students prefer this method of learning. Point of Care Ultrasound is becoming a necessary part of medical education, as its importance in clinical medicine grows. Near peer teaching can be one way to implement ultrasound into medical school curriculums.Item Presentations of Cutaneous Disease in Various Skin Pigmentations: Atopic Dermatitis(2023) Thompson, Jordan; Nguyen, Cecilia; Nguyen, Daniel; Wong, Christopher; Scheufele, Christian; Carletti, Michael; Weis, StephenBackground Atopic dermatitis (AD), commonly known as eczema, is a chronic inflammatory skin disorder classically affecting flexural areas of the body. It presents in any age group, but commonly develops during infancy and early childhood and morphologic subtypes exist due to varying skin tones. Children with darker skin were approximately six times more likely to develop atopic dermatitis in comparison to children with lighter skin. African American and Asian patients more frequently have atopic dermatitis compared to Caucasian patients. Presentations of atopic dermatitis vary due to duration, age and color of skin. Acute lesions are clinically characterized as ill-defined pruritic, erythematous plaques (raised, >1cm) while chronic lesions are dry, hyperpigmented plaques (raised, >1cm) with lichenification and prurigo nodules. Differential diagnosis includes scabies, seborrheic dermatitis, ichthyoses, and psoriasis. This review article will showcase clinical images with varying presentations of atopic dermatitis in ranging age groups and skin color according to the Fitzpatrick scale. Case Information The Fitzpatrick scale provides a classification system for an individual’s skin type based on the ability to burn and/or tan when exposed to ultraviolet light. It is used to approximate the degree of skin pigmentation. This review article focuses on 5 distinct cases of varying ages and skin types to present 5 atypical presentations of atopic dermatitis. Case 1 presents a 40-year-old, Fitzpatrick I, with chronic atopic dermatitis. Case 2 presents a 6-month-old, Fitzpatrick III, with acute atopic dermatitis. Case 3 presents a 11-year-old, Fitzpatrick IV, with subacute atopic dermatitis. Case 4 presents a 21-year-old, Fitzpatrick IV, with chronic atopic dermatitis. Case 5 presents a 3-year-old, Fitzpatrick V, with chronic atopic dermatitis. Discussion In the United States, atopic dermatitis affects approximately 11.3 – 12.7% and 6.9 – 7.6% of children and adults, respectively. Presentations of atopic dermatitis can vary due to duration, age and color of skin. Post inflammatory dyspigmentation is observed more in African American patients due to decreased healthcare access and different clinical manifestations, notably with erythema. Atopic dermatitis can have a significant quality of life impairment and disease burden in diagnosed individuals, especially those with darker skin pigmentation. The disease can progress to a systemic disorder, "atopic march” causing allergic conditions including asthma, allergic rhinitis and food allergies. Pruritus, a hallmark symptom of atopic dermatitis, may lead to increased sleep disturbances, fatigue, and mental health symptoms which ultimately affects growth, school performance, attention, and accident rates in children. Atopic dermatitis has been linked to attention-deficit hyperactivity disorder in children and increased rates of depression and anxiety in teengagers and adults. The purpose of this review article is to outline atypical presentations of atopic dermatitis to allow practitioners to gain a better understanding to aid in diagnosing patients with different skin tones.