Breakthroughs In Cervical Cancer Screening: Hpv Self-Collection At Pmg Milwaukie Family Medicine Clinic,
2026
Providence
Breakthroughs In Cervical Cancer Screening: Hpv Self-Collection At Pmg Milwaukie Family Medicine Clinic, Brandon Bartlett, Sataj Johnson, Emily Miyasako, Rachel Gallagher, Daniel Ruegg
Books, Presentations, Posters, Etc.
Background: Cervical cancer screening is a cornerstone of preventative healthcare and cancer screening in primary care. Based on data from the CDC, in the US alone, the rate of new cervical cancers each year is ~13,000, accounts for ~4,000 deaths annually, and disproportionally effects people of color and people of low SES (CDC, 2025). In our clinic (PMG Milwaukie), the rate of cervical cancer screening has remained around 70% for years, which is below the national average of ~75% (Healthy People, 2021). Primary HPV screening with self-collected swabs has been used successfully for years outside of the US, improving screening …
Improving Post-Hospital Medication Reconciliation In A Rural Primary Care Clinic Through An Rn-Led Workflow,
2026
Providence
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 …
Improving Recognition Of Chronic Kidney Disease In A Federally Qualified Health Center Through A Quality Improvement Initiative,
2026
Providence Hood River Family Medicine Residency Program, Hood River, OR, USA
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 …
Raising The Barb: Evaluation Of Phenobarbital Use For Alcohol Withdrawal In Patients On General Medicine Floors,
2026
Providence
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. …
A Rare And Fatal Complication Of Herpes Simplex Virus (Hsv) Infection,
2026
Providence
A Rare And Fatal Complication Of Herpes Simplex Virus (Hsv) Infection, Natalie Bolton, Jeffrey Youker
Books, Presentations, Posters, Etc.
Introduction: Hemophagocytic Lymphohistiocytosis (HLH) is a rare syndrome characterized by overactive immune activation, cytokine storm, and uncontrolled hemophagocytosis. Primary HLH is familial and most often seen in infants, whereas secondary HLH occurs more frequently in adults and is triggered by infections, malignancies, or autoimmune disorders. Clinically, secondary HLH often mimics sepsis but fails to respond to standard therapies, contributing to delayed diagnosis and treatment. Without timely intervention, HLH can result in extensive tissue damage, multiorgan failure, and death. In rare cases, central nervous system (CNS) involvement may occur, manifesting as histiocytic infiltration that can be misinterpreted as malignancy or infection. …
Behavior Change In A Young Woman: The Secret Lies In The Ovarian Tumor,
2026
Providence
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 …
Cloudy Consequences: Exploring Vaping-Induced Pulmonary Alveolar Proteinosis,
2026
Providence
Cloudy Consequences: Exploring Vaping-Induced Pulmonary Alveolar Proteinosis, Jennifer Wong, Do, Omar Pandhair, Abby Lindseth, Md, Cameron Miles Long, Md
Books, Presentations, Posters, Etc.
Abstract: Pulmonary alveolar proteinosis (PAP) is a rare disease caused by abnormal accumulation of surfactant within alveoli. Vaping of electronic cigarette smoke has recently been described as a cause of pulmonary alveolar proteinosis in two case reports. We add to this rare literature by describing a case of pulmonary alveolar proteinosis induced from vaping in a young woman with confirmed granulocyte/macrophage colony-stimulating factor (GM-CSF) autoantibodies as the proposed mechanism. Introduction: Pulmonary alveolar proteinosis (PAP) results from inappropriate accumulation of pulmonary alveolar surfactant due to dysregulated granulocyte/ macrophage colony-stimulating factor (GM-CSF) signaling.1 Its incidence is approximately 0.2 cases per million with …
Ecmo As A Bridge To Lung Transplant For Refractory Rapidly Progressive Interstitial Lung Disease,
2026
Providence
Ecmo As A Bridge To Lung Transplant For Refractory Rapidly Progressive Interstitial Lung Disease, Matthew Moritz, Omar Pandhair
Books, Presentations, Posters, Etc.
Anti-melanoma differentiation-associated gene 5 (MDA-5) antibody is most frequently associated with dermatomyositis with various degrees of clinical manifestations including rapidly progressive interstitial lung disease (RP-ILD), inflammatory arthritis, vasculopathy, and other cutaneous findings. Clinically amyopathic dermatomyositis (CADM) is frequently associated with RP-ILD and has high mortality rates. Here we present a case of anti-MDA5 associated RPILD but without other features of dermatomyositis that did not respond to standard immunosuppressive therapy. A 41-year-old woman with recently diagnosed interstitial lung disease and polyarthritis previously on methotrexate presented with progressive dyspnea and worsening hypoxemic respiratory failure. She was previously admitted for respiratory failure two …
Evaluating Outcomes Of Long-Acting Injectable Antiretrovirals For Hiv Treatment And Pre-Exposure Prophylaxis In A Pharmacist-Managed Clinic Setting,
2026
Providence
Evaluating Outcomes Of Long-Acting Injectable Antiretrovirals For Hiv Treatment And Pre-Exposure Prophylaxis In A Pharmacist-Managed Clinic Setting, Kaitlin Repass, Pharmd, Melissa Yokoyama, Pharmd, Farnaz Khoshnahad, Pharmd, Bcacp, Char Hunt, Pharmd, Ms, Bcacp
Books, Presentations, Posters, Etc.
No abstract provided.
Hydroxocobalamin In Septic Shock Management – Should It Be Introduced Sooner?,
2026
Providence
Hydroxocobalamin In Septic Shock Management – Should It Be Introduced Sooner?, Linh Tang Taylor, Md, Cameron Miles Long, Md, Omar Pandhair
Books, Presentations, Posters, Etc.
Introduction: Treating sepsis involves timely antibiotics, adequate fluid resuscitation, and vasopressor support if shock develops. Plasma concentrations of nitric oxide and hydrogen sulfides are elevated in early sepsis, contributing to vasoplegia,1 a pathology that isn’t addressed by vasopressors. High-dose hydroxocobalamin (vitamin B12) does, and therefore, has long been explored as a potential adjunct to vasopressors, though no consensus or official guidelines for its use have been published. Case Report: A 26-year-old man who was diagnosed with acute myeloid leukemia a few months prior presented to the emergency room for fever, weakness, and emesis. He was found to be profoundly hypotensive …
Hypercalcemic Crisis After Open Mitral Valve Replacement,
2026
Providence
Hypercalcemic Crisis After Open Mitral Valve Replacement, Andrew Sunwood, Do, Jason Heino
Books, Presentations, Posters, Etc.
59. Hypercalcemic Crisis After Open Mitral Valve Replacement Andrew Sunwood, DO Background: Hypercalcemic crisis is a rare manifestation of primary hyperparathyroidism characterized by a sudden increase in serum calcium levels to >14 mg/dL with symptoms of hypercalcemia including adverse gastrointestinal symptoms, abdominal pain, and even predisposition to cardiac arrhythmias. There is only one other documented case of hypercalcemic crisis occurring after open heart surgery. Case information: 69-year-old female with a history of primary osteoporosis on alendronate and valvular heart failure presented for mitral valve replacement. Preoperative lab work did not show evidence of electrolyte abnormalities. She under- went open bioprosthetic …
A Case Of Pembrolizumab Associated Sjs/Ten Spectrum Reaction,
2026
Providence
A Case Of Pembrolizumab Associated Sjs/Ten Spectrum Reaction, Lauryn Orsillo, Do, Alex Zhu, Md, Linh Tang Taylor, Md
Books, Presentations, Posters, Etc.
Introduction: Immune checkpoint inhibitors (ICIs), such as pembrolizumab, are becoming increasingly more common.1 They are associated with a variety of cutaneous immune-related adverse events which can range from drug eruptions to life-threatening Stevens–Johnson syndrome (SJS)/ toxic epidermal necrolysis (TEN) spectrum reactions.2 As use of these ICIs and PD1 inhibitors expands, the incidence of severe dermatologic toxicity can be expected to rise. Early recognition is critical, as SJS/TEN spectrum reactions carry substantial morbidity and mortality compared with drug eruptions. Case report: An 80-year-old female with a history of triple-negative breast cancer on pembrolizumab presented to the ED for evaluation of a …
Implementation And Impact Of The Transition Series For Senior Residents In Internal Medicine Residency,
2026
Providence
Implementation And Impact Of The Transition Series For Senior Residents In Internal Medicine Residency, Abby Lindseth, Md, Jeffrey Youker
Books, Presentations, Posters, Etc.
The transition from medical student to intern is widely recognized as a challenging period, and numerous curricula have been developed to support this transition. However, the transition from intern to senior resident receives far less attention despite presenting its own unique challenges. Anecdotal feedback from internal medicine residents and emerging literature suggests that the transition to senior resident is associated with feeling emotionally overwhelmed from simultaneously being a learner, leader and educator.1,2 To address this gap, the Transition Series was developed as a novel curriculum to support internal medicine residents as they advance into their senior roles. Building on the …
Phenazopyridine-Induced Sulfhemoglobinemia: A Diagnostic And Management Dilemma,
2026
Providence
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. …
A Fatal ‘Sepsis’: Intravascular Large B-Cell Lymphoma In Disguise,
2026
Providence
A Fatal ‘Sepsis’: Intravascular Large B-Cell Lymphoma In Disguise, Jennifer L. Wong, Do1, Jared A. Shipley, Md2, Christine Johnson, Md3
Books, Presentations, Posters, Etc.
Introduction: Intravascular large B-cell lymphoma (IVLBCL) is a rare, aggressive subtype of non-Hodgkin lymphoma characterized by selective proliferation of neoplastic cells within small vessel lumina. Cases in Western countries more commonly involve the central nervous system or skin, whereas patients in Eastern regions often present with hemophagocytic syndrome or medullary disease. The absence of lymphadenopathy, low circulating tumor burden, and subtlety of morphologic clues contribute to delays in diagnosis. By presentation, most have advanced disease, and a substantial proportion are diagnosed only at autopsy. We report a unique case with mixed features who manifested respiratory involvement and ultimately suffered cardiovascular …
Pulmonary Pseudomyxoma Peritonei,
2026
Providence
Pulmonary Pseudomyxoma Peritonei, Hannah Kirk, Do, Omar Pandhair
Books, Presentations, Posters, Etc.
Introduction: Pseudomyxoma peritonei (PMP) is an intra -abdominal cancer occurring in one to four out of one million patients. It begins as a mucinous adenocarcinoma of the appendix that implants on other peritoneal surfaces, spreading into gelatinous ascites. Treatment consists of hyperthermic intraperitoneal chemotherapy (HIPEC) and cytoreductive surgery (CRS). Extra -abdominal metastases are rare. We present the case of a patient who underwent treatment for PMP and was found to have lung nodules over a decade later. Case Presentation: A 73 -year -old woman with pseudomyxoma peritonei presented to the emergency department with progressive dyspnea and unintentional weight loss. Twenty …
Puzzling Papules: Uncovering The Etiology Of A Rash In A Returning Traveler,
2026
Providence
Puzzling Papules: Uncovering The Etiology Of A Rash In A Returning Traveler, Lisa Stampke, Md, Shahana Baig-Lewis, Md
Books, Presentations, Posters, Etc.
Introduction: There are an estimated 1.8 billion people that travel internationally every year [1]. Approximately 22-64% of those acquire an infectious disease during or after returning home that is not endemic to their home country [1]. This is especially concerning in our current political climate and declining vaccination rates in the United States which places more patients at risk for preventable diseases [2]. These factors present a unique challenge in diagnosing and treating a symptomatic returning traveler. Case Description: A 25-year-old incompletely vaccinated male returned from Kenya after volunteering for 5-weeks in a rural hospital. He was in his usual …
Efficiency Rx: Emr Training For Resident Wellness,
2026
Providence
Efficiency Rx: Emr Training For Resident Wellness, Calder Dorn, Do, Tom Chau, Md, Mba, Facp, Shelley Schoepflin Sanders, Md, Facp
Books, Presentations, Posters, Etc.
Introduction: Physician burnout affects nearly 60% of physicians during their careers, leading to increased medical errors, reduced care quality, higher turnover, and lower patient satisfaction. ii. The widespread use of Electronic Medical Records (EMRs) has been identified as a key contributor, with poor usability, inbox overload, and documentation burden reducing direct patient interaction among cited factors iii. Institutions like UCHealth, OHSU, CHOP, and Mayo Clinic have implemented strategies that improved EMR confidence and reduced burnout vi. While Providence offers training to all providers, there are no initiatives specifically targeted to internal medicine (IM) residents. Methods: Providence St. Vincent Medical Center …
Snuggles, Not Struggles: Evaluation Of A Post-Operative Pain Management Protocol In A Level Iii Community Nicu,
2026
Providence
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 Rash After The Remedy,
2026
Providence
The Rash After The Remedy, Elaine Chen, Md
Books, Presentations, Posters, Etc.
Introduction: Trimethoprim/sulfamethoxazole (TMP/SMX) is a widely prescribed and generally well-tolerated antibiotic. Cutaneous reactions occur in up to 4% of patients, including morbilliform rash, urticaria, DRESS, Stevens-Johnson syndrome, and toxic epidermal necrolysis. More rarely, TMP/SMX can trigger leukocytoclastic vasculitis (LCV), a small-vessel vasculitis characterized by neutrophilic infiltration, fibrinoid necrosis, and leukocytoclasia. LCV typically manifests as palpable purpura on dependent areas. While often skin-limited, systemic involvement may occur. We present a case of TMP/SMX-induced LCV with multi-organ features. Case description: A 53-year-old healthy male presented to urgent care with dysuria. Urine culture grew pan-sensitive E. coli, and he completed a 7-day course …
