14 patients in 4 hours! Wow. But time flies when you're learning more than you can possibly absorb, understand, or make connections to your classwork! It was a whirlwind of an afternoon with Dr. R, my preceptor for my outpatient rotation. He is a fast walking and fast talking short man who mixes up his 'v' and 'b' sounds because his first language is Spanish. (Which actually reminds me of my Pap-pap, so that's kind of nice!)
We saw women for their yearly exam and Pap smear, women who were 16 weeks or 24 weeks or 36 weeks pregnant, a woman who gave birth 6 weeks ago and was in for her postpartum exam, a 74 year old woman with lower right abdominal pain, and two women in their early 30s who each had constant heavy bleeding and were there to ask Dr. R for a hysterectomy. I need to take a notepad with me this week to take notes on things I need to look up, questions to ask Dr. R after the patient leaves, and tidbits I learn along the way.
Tidbits from last week:
- Starting in the second trimester, fundal height, the distance from the pubic bone to the top of the uterus, in centimeters generally equals the number of weeks along in the pregnancy... 32 weeks along means a 32 cm belly!
- 10% to 30% of pregnant women are colonized (but not sick) with group B strep in the genital tract - not really a problem for healthy adults. But this does put the baby at risk for sepsis (infection of the bloodstream) and meningitis (infection of the lining and fluid surrounding the brain) and a common cause of pneumonia if this bacteria is passed on during the birthing process. Dr. R, and most other doctors in the US, test all pregnant women for group B strep at some point in their pregnancy and treat both the mom and the baby with antibiotics at the time of delivery if the culture is positive.
... and it just so happens we learned about this very thing in Infectious Disease class today! Med school does work :)
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