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Site Evaluation Presentation

During my OB/GYN rotation, I had the privilege of completing my evaluation with Carlos Melendez, who not only served as my evaluator but was also our OB/GYN professor during the didactic year. This evaluation provided an opportunity to demonstrate my clinical knowledge, critical thinking, and ability to synthesize information from my experiences throughout the rotation.

As part of the evaluation, I presented two cases. The first involved a patient with chronic pelvic pain exacerbated by sexual intercourse. Her symptoms coincided with the placement of a copper IUD a year prior, and her history included recurrent urinary tract infections and a urethral diverticulum. The differential diagnosis included urethral diverticulum, vulvovaginal candidiasis, bacterial vaginosis, and endometriosis. The treatment plan focused on removing the copper IUD, treating potential vaginal infections, scheduling an endometrial biopsy to evaluate atypical glandular cells noted on a Pap smear, and referring her to urology for further evaluation.

The second case involved a patient at 34 weeks of gestation who presented with elevated blood pressure and a mild headache. Her differential diagnosis included gestational hypertension, preeclampsia without severe features, and chronic hypertension with superimposed preeclampsia. The patient was admitted for blood pressure monitoring, laboratory evaluations, and fetal well-being assessments, with plans to monitor for severe preeclampsia features and consider magnesium sulfate for seizure prophylaxis if necessary.

To supplement the discussion, I presented an article related to the second case. The study examined the effects of maternal antihypertensive drugs, such as labetalol, on oxygen extraction in preterm neonates. It highlighted the potential impacts of these medications on neonatal hemodynamics and emphasized the importance of precise monitoring in neonates exposed to maternal antihypertensive drugs for conditions like preeclampsia.

Overall, the evaluation was an excellent learning experience. It challenged me to apply clinical reasoning, integrate current research into patient care discussions, and articulate my findings effectively. Professor Melendez’s guidance and feedback were invaluable, reinforcing key clinical concepts and encouraging me to think critically about complex OB/GYN cases. This experience not only deepened my understanding of the specialty but also enhanced my confidence in presenting and managing diverse clinical scenarios.