Medical Education Commons^™

Snuggles, Not Struggles: Evaluation Of A Post-Operative Pain Management Protocol In A Level Iii Community Nicu, Maleane Chin, Danielle Megano, Aiyana Ooki-Knutson, Deasy Erin Wilson

Books, Presentations, Posters, Etc.

Abstract: Neonates are an extremely sensitive population often subject to painful interventions. This pain can have numerous adverse effects including physiologic instability, altered brain development, and abnormal stress responses, which can persist into childhood. Effective post-operative pain management for neonates is crucial for promoting positive developmental outcomes. No specific post-operative pain protocol for neonatal patients has shown to be most effective, so the American Academy of Pediatrics recommends that healthcare institutions establish a neonatal pain protocol to provide more standardized care. This project is a retrospective, single center observational study determined to be exempt by the institutional review board. Infants …

The Power Of Two Questions: A Simplified Approach To Delirium Detection, Dalton Vanderpol, Md, Laura Perry, Shelley Schoepflin Sanders

Books, Presentations, Posters, Etc.

Background: Delirium affects one-third of general medical patients aged 70 or older. Patients with older age, preexisting dementia, or cognitive impairment are at increased risk of developing delirium. Delirium is associated with increased length of stay, mortality, transfer to skilled nursing facilities, and costs. Although the Confusion Assessment Method (CAM) is a validated tool for delirium, its sensitivity can be low when administered by nurses because of its subjective nature and the need for formal training. The Ultra Brief Confusion Assessment Method (UB-CAM) is an objective, two-question test administered in 30-35 seconds compared to 5-10 minutes for CAM. The objective …

When Jaundice Isn’T Just The Liver’S Fault: A Chilly Case Of Cold Autoimmune Hemolytic Anemia, Jennifer Wong, Do, Shahana Baig-Lewis, Md, Mph

Books, Presentations, Posters, Etc.

Introduction: Cold agglutinin disease (CAD), a subtype of autoimmune hemolytic anemia (AIHA), is characterized by IgM autoantibodies that target red blood cell antigens at low temperatures, leading to agglutination in cooler peripheral tissues and hemolysis. Predominately directed against the “I” or “i” antigens, cold agglutinins are commonly associated with Mycoplasma pneumoniae and infectious mononucleosis. Distinguishing warm AIHA from CAD can be challenging. Definitive diagnosis relies on antibody testing, with warm AIHA primarily involving IgG and CAD involving IgM. We report a case of CAD initially misattributed to drug-induced liver injury in the setting of a viral upper respiratory infection. Case …

Improving Post-Hospital Medication Reconciliation In A Rural Primary Care Clinic Through An Rn-Led Workflow, Jack Kennady

Books, Presentations, Posters, Etc.

Context/background: Adverse events after hospital discharge are common and represent a major patient safety concern. Approximately 1 in 5 patients experience a safety event after discharge, and 39% of these events are adverse drug events (ADEs), with 26% considered preventable. Medication discrepancies during transitions of care contribute significantly to these events, with an estimated 40% of medication errors resulting from inadequate medication reconciliation. Rural primary care clinics face additional challenges, including limited communication between inpatient and outpatient systems and inconsistent reconciliation workflows. Improving medication reconciliation during the transition from hospital discharge to outpatient follow-up represents an important opportunity for family …

Diagnostic Overlap In Hus: An Atypical Case, Ryan Daily, Med, Do, Andrea Roast, Md

Books, Presentations, Posters, Etc.

Introduction: Atypical HUS (aHUS) is a rare type of Thrombotic Microangiopathy distinguished by complement dysregulation and overall clinical progression. We present a diagnostically ambiguous case with early intervention that preserved end-organ function with discussion of future pregnancy implications. Case Presentation: A 36yo F (G2P1) with hypothyroidism, Small Intestinal Bacterial Overgrowth (SIBO), and intermittent urticarial rashes presented with fever, abdominal pain, and 3 days of bloody diarrhea. Discussion: This case highlights an atypical presentation of aHUS with diarrheal prodrome and normal complement function, features that typically suggest Shiga toxin–mediated HUS. We saw clinical change after admission, allowing real-time monitoring. Maintaining a …

Phenazopyridine-Induced Sulfhemoglobinemia: A Diagnostic And Management Dilemma, Natalie Bolton, Md, Linh Tang Taylor, Md, Kristy Poonyagarlyagorn, Md, Cameron Long, Md

Books, Presentations, Posters, Etc.

Introduction: Sulfhemoglobinemia is a rare dyshemoglobinemia which occurs when sulfur irreversibly binds to hemoglobin. Presents similarly to methemoglobinemia. Common offending medications: dapsone, acetanilide, phenacetin, and nitrates. Rarely observed secondary to phenazopyridine, an over-the counter medication used to treat dysuria. Few facilities are capable of testing for sulfhemoglobinemia Case Background: A 67-year-old woman with recurrent urinary tract infections and interstitial cystitis presented with encephalopathy and recurrent falls for three days. PMH: multiple sclerosis, recurrent urinary tract infections, asthma, neurogenic bladder, neuropathic pain, and obstructive sleep apnea. Chronically on multiple centrally acting medications. Not on medications for multiple sclerosis due to cost. …

Improving Cervical Cancer Screening At Pmg Southeast Family Medicine Through Implementing A New Screening Tool: Patient-Collected High-Risk Hpv Screening, Brianna Pickering, August Stuppy, Eric Waelbroeck, Ben Pederson, Daniel Ruegg

Books, Presentations, Posters, Etc.

No abstract provided.

Improving Recognition Of Chronic Kidney Disease In A Federally Qualified Health Center Through A Quality Improvement Initiative, Rachel Monroe, Evan Saulino, Kathleen Mckenna

Books, Presentations, Posters, Etc.

Context/background: Chronic kidney disease (CKD) affects approximately 15% of adults in the United States, yet nearly 90% of affected individuals are unaware of their diagnosis. Early identification in primary care enables interventions such as blood pressure optimization, renin –angiotensin system blockade, and kidney -protective medications that can significantly delay disease progression and postpone dialysis. Screening and diagnosis gaps disproportionately affect high -risk populations, including Latinx patients and immigrant agricultural workers commonly served in federally qualified health centers (FQHCs). National CKD screening rates among patients with diabetes or hypertension remain low, leaving many high -risk individuals unscreened for kidney disease. Improving …

Behavior Change In A Young Woman: The Secret Lies In The Ovarian Tumor, Matthew Moritz, Md, Linh Tang Taylor, Md, Olivia L Snir, Stephanie Griffith, Md

Books, Presentations, Posters, Etc.

Introduction: Autoimmune encephalitis is a rare immune-mediated disorder characterized by neuropsychiatric symptoms. Anti-NMDA receptor (NMDA-R) encephalitis, the most common subtype, affects approximately 1 in 1.5 million people annually. We present a case of a young female with new-onset hallucinations, behavioral changes, and personality disturbance. Case Presentation: A 32-year-old female with remote methamphetamine use and recent trauma presented with acute mental status changes, aggression, emotional lability, and hallucinations. Vitals were normal; on exam she appeared confused, agitated, and displayed unusual behavior, including hallucinations. Initial evaluation revealed mild leukocytosis, but otherwise normal urine drug screen, chest radiograph, TSH, ANA, VDRL, heavy metal …

Powering Up Clinical Scholarship In Santa Fe Family Medicine, Evelyn Wang

HSLIC Faculty and Staff Instructional Resources

This presentation introduces family medicine residents and faculty in Santa Fe to clinical scholarship pathways, highlighting research question formulation, literature search strategies, full-text access tools, and HSLIC services that support evidence-based practice, quality improvement, and publication.

Spur Cell Anemia: A Crucial Unanticipated Anemia In Critical Care, Jobe Ashby

Books, Presentations, Posters, Etc.

INTRODUCTION: Spur Cell Anemia (SCA) is a rare underrecognized non-autoimmune hemolytic anemia occurring in severe liver disease with prognostic implications. Since the 1980s there have been only a few dozen case reports and clinical images concerning SCA. We present a case of a young man managed in the ICU with multiorgan failure and a masked diagnosis of SCA. DESCRIPTION: A 33-year-old man was found down and presented to the ICU with hematemesis and hemorrhagic shock. He required massive transfusion for bleeding esophageal varices that were later banded and an expanding thigh hematoma. He was diagnosed with alcohol induced liver cirrhosis …

Supplement Risk, Allison Connor, Bs, Linh Tang Taylor, Md, Jeffrey Youker, Md

Books, Presentations, Posters, Etc.

Introduction: Increasingly, it is the case that patients are using a variety of supplements. About half of American adults use supplements. ¹. The purpose of this case report is to consider the impact of surreptitious supplement use on clinical presentation and under score the value in gathering a robust patient history. Case report: A 58-year-old man with prior history of infective endocarditis (IE) resulting in bioprosthetic aortic valve replacement (2 years prior) presented with worsening left lumbar pain and low-grade fever. He was found to have Methicillin resistant Staphylococcus aureus bacteremia with L4/5 vertebral osteomyelitis and a left psoas abscess. …

Acute Pancreatitis Outcomes In Native Americans In Northern Arizona, Jin Yun Do1, Afsheen Moshtaghi Do2, Hamza Khan, Md2, Hady Shahbaz Bs2, Yoshinobu Koguchi, Tarsem L. Moudgil, Noah D. Simons, Venkatesh Rajamanickam

Books, Presentations, Posters, Etc.

Background and Aims: Prior studies have shown the impact of racial and ethnic disparities in outcomes of acute pancreatitis (AP). Data remains sparse for Native American populations, who may be uniquely affected by socioeconomic and geographic factors. This retrospective study aimed to evaluate the disproportionate outcomes of AP in Native Americans compared to the general population in Northern Arizona. Methods: A retrospective cohort study of hospitalized patients with AP at two community hospitals in Northern Arizona. A total of 1,113 patients between Jan and Aug 2024 were included, comprising 413 Native American patients and 700 patients of other racial backgrounds. …

A Case Of Sweet Syndrome In A Patient With Myelodysplastic Syndrome, Malia’Ka Hall, Do, Elizabeth Hutshinson, Md

Books, Presentations, Posters, Etc.

Introduction: Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory disorder characterized by the abrupt onset of high fevers and exquisitely tender, erythematous skin lesions that may appear on virtually any area of the body. These lesions typically manifest as papules, nodules, or plaques and often evolve rapidly, contributing to the dramatic clinical presentation. Although uncommon—with only several hundred cases documented in the literature—Sweet syndrome remains an important diagnostic consideration due to its distinctive combination of cutaneous findings and systemic symptoms, as well as its potential association with underlying malignancy, infection, or medication exposure. Presentation: A …

Addition Of Gitr Agonist To A Dark Matter Cancer Vaccine And Anti-Pd-1 Increases Regulatory T Cell Numbers Without Appearing To Impact Therapeutic Efficacy, Rom S. Leidner1, Guo Hui Gan1, Christopher C. Paustian, Shawn M. Jensen

Books, Presentations, Posters, Etc.

Background: DPV-001 is an off-the-shelf cancer vaccine containing tumor associated proteins commonly overexpressed in adenocarcinoma and squamous cell carcinoma. It is enriched for short-lived proteins (SLiPs) and defective ribosomal products (DRiPs), including both canonical and non-canonical (or “dark matter”) antigens —comprising over 100 identified non-canonical microproteins. These antigens are delivered in spectrin-coated microvesicles that contain 5 TLR/ NOD agonists and 15DAMPs/molecular chaperones, and target CLEC9A+ conventional dendritic cells (cDCs). Preclinical models showed enhanced antitumor responses when the murine analog of DPV-001 (DRibbles) was combined with co -stimulatory agonists. Additional studies showed enhanced antitumor responses when co-stimulatory agonists were combined with …

Acquired Amegakaryocytic Thrombocytopenia And Pure Red Cell Aplasia As Initial Presentation Of Thymoma, Nidhi Patel, Md, Natasha Edwin, Md

Books, Presentations, Posters, Etc.

Introduction: Pure Red Cell Aplasia (PRCA) is a common feature of thymomas, but it rarely presents with acquired amegakaryocytic thrombocytopenia (AAMT). Here, we present a case of a 59-year-old male with fatigue found to have severe anemia and thrombocytopenia, who was eventually diagnosed with a thymoma Case Presentation: Found to have Hg of 6.1 g/dL and platelet count of 33 k/uL; Reticulocyte count was 0.0068. CT chest showed an anterior mediastinal mass measuring 4.5 x 6.6 cm. Mass biopsy showed thymoma. Bone marrow biopsy showed 50% cellularity with absence of erythroid and megakaryocyte precursors compatible with AAMT and PRCA. At …

Beyond The Negative Serologies: A Case Of Fulminant Vasculitis, Multiorgan Dysfunction, And An Uncharacteristic Infection, Guo Hui (Greyson) Gan, Do

Books, Presentations, Posters, Etc.

Case Presentation: 70-year-old male presented with one week of fever and a painful right lower extremity purpuric rash that rapidly evolved into fullthickness desquamation and necrosis. Concurrent multiorgan dysfunction: respiratory failure, renal failure with nephritic proteinuria, and severe thrombocytopenia refractory to high dose steroids. Extensive serologic workup for viral, autoimmune, vascular, and hematologic etiologies were pan-negative, including serum cryoglobulins twice repeated (QR code for table of workup). A PET scan for a broad evaluation found a hypermetabolic right inguinal lymph node. Discussion: Unique features of this case: His hematologic workup was convincingly negative in setting of having type 1 CryoGN. …

Ceftriaxone-Induced Thrombocytopenia: An Atypical Presentation Of A Commonly Used Antibiotic, Matthew Moritz, Omar Pandhair

Books, Presentations, Posters, Etc.

INTRODUCTION: Drug-induced thrombocytopenia (DITP) is rare and impacts roughly ten persons per million people annually (1). Over one-hundred medications have been identified as possible offenders, with immune response occurring within one to two weeks of drug exposure (2). Here we present a case of ceftriaxone as cause of DITP, an extremely rare complication of a commonly used antibiotic. CASE PRESENTATION: A fifty-year-old male with diabetes and depression initially presented after attempted suicide by hanging. He was intubated in the field and admitted directly to the intensive care unit (ICU). He remained in the ICU due to persistent encephalopathy which was …

Individuals Deemed Low Risk For Cardiotoxicity With Her2-Directed Antibody Therapy Developed Modest Incidences Of Treatment-Related Lvef Decline And Heart Failure Across A Large Western Us Hospital System, Cameron Smith1, David Page1, Michael Layoun, Li Hsin-Fang

Books, Presentations, Posters, Etc.

Background: Incidence of anti-HER2 cardiotoxicity varies widely from 3-30%. Baseline cardiac risk factors can drastically affect an individual's risk of cardiotoxicity while on anti-HER2 therapies. Risk stratification calculators like the HFA-ICOS tool can estimate relative risk of cardiotoxicity based on preceding risk factors. High risk factors: Heart failure (HF), CAD, severe valvular heart disease. Mild-moderate risk factors: HTN, DM, CKD, age 65-79, anthracycline use, arrhythmia, smoking history, BMI>30. De-intensified surveillance has been proposed for low-risk patients. Objective: Characterize incidence and predictors of cardiotoxicity in a real world population of early-stage breast cancer patients receiving anti-HER2 therapies. Evaluate incidence of …

Postpartum Spontaneous Coronary Artery Dissection With Multivessel Arteriopathy, Devon Schaefer, Do, Cody Paiva, Do

Books, Presentations, Posters, Etc.

Case Presentation: Hospital Day 0 – Presentation: 43-year-old postpartum female (s/p C-section 4-months prior) presenting with recurrent central chest pressure after several days of intermittent symptoms. She was hemodynamically stable but had diffuse T‑wave inversions and a marked troponin rise. Treated with aspirin, nitroglycerin, and heparin for presumed NSTEMI. Coronary angiography planned. Hospital Day 1 -- Initial Angiography: TTE showed mildly reduced EF with apical akinesis. Angiogram read as mild diffuse mid-distal LAD disease (Figure 1), but no evidence of obstructive disease or culprit lesion. Working diagnosis was MINOCA, stress cardiomyopathy, or an occult SCAD. Hospital Day 2 -- Diagnostic …

Visual Cues And Pharmacy Pathways Improve Hypertension Management In A Resident Clinic, Gage Lemunyan M.D., Cody Paiva, Do, Mari Kai, Md

Books, Presentations, Posters, Etc.

Background: Managing hypertension in ambulatory settings is becoming increasingly challenging, often competing with other visit priorities. “White coat hypertension” remains a key consideration when considering initiating or increasing anti-hypertensives. Blood pressure may be transiently elevated on initial screening and improve on recheck. Problem: In our clinic, only ~55% of patients were at goal, defined as BP < 140/90 at last office visit. • < 50% of patients received serial recheck after identifying an elevated reading. • 43% of same-day rechecks were < 140/90. Aim: Enhance hypertension management using low-cost, easy to implement interventions. Results: Process was examined iteratively, starting with a yellow card that was placed on the door to alert clinicians to the need to recheck blood pressure before discharge. This was continually refined based on staff feedback. Visual cues prompted more frequent rechecks by rooming staff, increasing the rate of those with elevated initial reading who had serial recheck from 48% to 69%, a net increase of 21%. Improvement was seen in clinic-wide blood pressure control, with the percentage of patients with a blood pressure < 140/90 at most recent office visit increasing from 55.7% to 66.6% after 1 year. This represented a net increase of 10.9%. Discussion: Visual cues in the exam room were effective at alerting clinicians for the need for serial BP recheck. These were most-effective when they were “eye catching”. PharmD visits were effective at creating a visit to focus solely on hypertension management, thereby eliminating competing interests that may dominate office visits with their primary care provider. These paired interventions were surprisingly effective at halting clinical inertia and ultimately led to more effective management of hypertension clinic-wide. Team-based EMR messaging was particularly helpful as an adjunct for coordinating timing of blood pressure rechecks. In a residency setting, this can be performed while ‘staffing’ with a faculty physician. Limitations: Current guidelines identify blood pressures >130/80 as hypertensive. This study utilizes 140/90 as a cutoff. Frequency of blood pressure rechecks highly variable based on available support staff. May place strain on support staff when short staffed. PharmD involvement may not be available in every setting

Revolutionizing Hematology/Oncology Education With Visual Storytelling And “Gamification” For Internal Medicine Residents, N Smith1, A Patel1, J Dechet, C Powell

Books, Presentations, Posters, Etc.

Introduction: Hematology/oncology ranks among the lowest scoring sections on in-training exams for internal medicine residents. Prior resident feedback expressed a need for an improved didactic curriculum that was applicable to internal medicine residents and board examinations Aim: To enhance curriculum through multimodal education by integrating traditional didactic presentations along with specific lectures utilizing visual storytelling, memory palaces, and gamification. Methods: Trainees completed a 5-point Likert scale survey on their perceptions of hematology and oncology with a 16-question quiz before and after the curriculum. Multimodal lecture series created using "murder mystery" and "jewel heist" to teach hemolytic anemia, team-based Jeopardy-style format …

Raising The Barb: Evaluation Of Phenobarbital Use For Alcohol Withdrawal In Patients On General Medicine Floors, Seth Arakawa, Jason Frederick, Anthony Le

Books, Presentations, Posters, Etc.

Abstract: Alcohol withdrawal syndrome (AWS) can present as a spectrum of symptoms such as a mild headache, gastrointestinal issues, and diaphoresis. However, if not treated properly, it can progress to severe hallucinations, seizures, or delirium tremens. Current guidelines from the American Society of Addiction Medicine (ASAM) recommend benzodiazepines as first line agents for alcohol withdrawal with phenobarbital recommended as an adjunct agent or replacement to benzodiazepines by providers who are familiar with its use. Although most evidence supporting phenobarbital in AWS comes from critical care settings, emerging data suggest it may also be safe and effective in general ward patients. …

Optimizing Behavioral Health Integration In Primary Care Through A Targeted Didactic, Ravneet Dhaliwal, M.A., Behavioral Health Intern, Joshua Morris

Books, Presentations, Posters, Etc.

Background: The integration of behavioral health into primary care settings is an essential strategy for improving patient outcomes, increasing access to mental health services, and achieving the Triple Aim of healthcare.1, 2 To maximize this integration and bridge the gap for primary care providers (PCPs), targeted didactic training and continued education are pivotal. National surveys indicate that PCPs often report low comfort levels in managing psychological concerns due to a lack of formal training, despite the high prevalence of these issues in primary care. 3, 4 Brief didactics facilitated by embedded behavioral health psychologists offer an accessible, adaptable method for …

Interactive Associations Between Physical Activity And Sleep Architecture On Cognition In Community-Dwelling Older Black Adults, Joshua L. Gills, Anhiti Dharmapuri, Rachel Mccray, Shreshtha Shah, Anthony Q. Briggs, Purbanka Pahari, Dominique Tanner, Mark A. Bernard, Elena Valkanova, Korey Kam, Ankit Parekh, Lisa L. Barnes, Gbenga Ogedegbe, Omonigho M. Bubu

International Journal of Exercise Science: Conference Proceedings

Growing evidence suggests an interactive relationship between physical activity (PA) and sleep in shaping cognitive performance. Enhanced sleep features, like greater K-complex density and slow-wave activity, may reflect mechanisms through which PA and restorative sleep improve cognitive function. PURPOSE: To examine how PA and sleep architecture interact to influence cognition in older Black adults. METHODS: A cross-sectional study of 51 participants (mean age: 63.1 ± 15.8 years) from NYU’s Aging Research In Sleep Equity and Dementia Prevention Program. Participants underwent neuropsychological testing, polysomnography, clinical evaluation, and seven days of actigraphy to assess PA and sedentary behavior. Cognitive tasks measured processing …

Use Of Resistive Exercise Snacks To Improve Upper Body Fitness In Undergraduate And Graduate Students, Zachary Abouelkawaam, Kevin Vaughan, Alexander Rothstein, Abdelmohsen Mossolem, Jean-Paul Dodier, Carlos Africa, Freddie Leong, John Handrakis

International Journal of Exercise Science: Conference Proceedings

Graduate/undergraduate students lack time for consistent physical activity, leading to declines in fitness. Exercise snacks (ExSnck), short bouts of submaximal exercise performed throughout the day, may offer a solution. PURPOSE: To evaluate the effects of a 6-week upper body ExSnck program on endurance, strength, power, and enjoyment compared to a 1-set maximal exercise (MaxEx) protocol and a control group. METHODS: 43 participants were randomly assigned to ExSnck (n=15), MaxEx (n=16), or Control (n=12) groups. The ExSnck group performed 33% of their maximal push-ups and plank time for 3 sessions/day (sessions ≥2hrs apart). The MaxEx group performed the same …

Association Between Coaching Behavior Styles And Athlete Well-Being: A Systematic Review, Matthew Benavides, Olivia Evola, Devjja V. Joshi, Arpita M. Bedarkar, Amerigo Rossi

International Journal of Exercise Science: Conference Proceedings

Coaching behavior plays a critical role in shaping athlete outcomes, including motivation, performance, satisfaction, and burnout. PURPOSE: Evaluates how different coaching styles are associated with athlete well-being and the psychological mechanisms involved. METHODS: A detailed search of ProQuest, Gale and EBSCO databases was done. Five peer-reviewed studies that met the inclusion criteria of college student athletes competing in NCAA or NAIA in the US or Canada and studies involving the coaching styles of either autocratic, democratic, transformational, congruent leadership or intrinsic motivation were systematically reviewed. 1,900 athletes were evaluated in the included studies of relationships between coaching behaviors and student …

Intouch Week Of April 27, 2026, New York Medical College

InTouch

• Tracey Milligan, M.D., FAAN, and Sarah Parauda, M.D., Honored on National Stage with Top Neurology Awards
• White Coat Ceremony Ushers SLP Class of 2027 into Clinical Training
• D.P.T. Class of 2028 Steps into Clinical Education
• SOM Class of 2028 Marks Milestone as Clinical Training Begins
• NYMC Celebrates Earth Day with Campus Sustainability Initiatives
• A Pawsitive Break for the NYMC Community
• Student Spotlight: Ashley Abing-Mesropyan Follows a Path Towards Meaningful Care

An Ot Educational Program For Individuals With Upper And Lower Limb Amputations, Laurie R. Spinks Mrs, Cassandra Nelson

Spring 2026 OTD Capstone Symposium

An OT approach to reducing prosthetic abandonment with an accessible guide to promote self sufficiency and community connections for individuals with amputations.

Psychological Safety In Health Care: A Prerequisite For High Reliability, Sonali Thosani

Advances in Cancer Education and Quality Improvement

This paper presents a viewpoint on how psychological safety contributes to patient safety, teamwork, and high reliability.