During my first site visit, we discussed a patient that I had seen as a follow up in the Family Medicine office. The patient had previously visited for a follow up due to dysmenorrhea the patient experienced. She had a pelvic ultrasound which revealed multiple left ovarian cysts. When I saw her, she presented for follow up of transvaginal ultrasound which confirmed that she did not have any cysts, but rather had a possible fibroid as well as adenomyosis. During the site eval, we discussed the difference between fibroids and adenomyosis. A fibroid is benign growth of fibrous tissue which develops in the wall of the uterus from endometrial tissue. Adenomyosis occurs when the tissue of the endometrium grows in the myometrial wall. We discussed the symptoms that occur with adenomyosis and the possible methods of treatment. The second patient that I had prepared for the site visit also detailed a patient that presented for routine follow up. Of note, the patient had a positive FOBT and has not yet scheduled an appointment with GI. The patient was reminded of the importance of scheduling this appointment. We also reviewed the importance of Family Medicine visits and the most common presentations which patients presented with. We also discussed diabetes treatment and the increasing prevalence of the use of diabetic drugs for weight loss. Lastly, I prepared five drug cards for my visit which we discussed.

For my second site visit, I presented a patient that presented for monitoring of tinea cruris. The patient had previously been seen in the clinic for the same complaint which was not resolving. While the patient was originally treated with Clotrimazole cream, the patient was then switched to Fluconazole. The provider that I was with advised the patient to use Fluconazole and avoid tight fitting clothing that might aggravate the rash. During this site visit, I also presented an article which related to this case. The article compared the efficacy of Terbinafine and Fluconazole based on various dosing regimens. The article concluded that Terbinafine may be slightly more beneficial. Throughout the site visit, we also discussed possible other treatment options for this patient. This encouraged me to practice critical thinking and broaden my thinking in regards to patient’s treatment regimens. At this site visit we also discussed five drug cards which I prepared for this visit.