28 Sep Telehealth / Transgender

NU664B Primary Care of Family I

Week 1 Discussion

Telehealth / Transgender

Imagine that you are a primary care provider in the middle of your busy Thursday. Your 10:30 a.m. telehealth appointment is as follows:

 

HPI: An otherwise healthy 35-year-old transgender woman on hormone suppressant therapy presents with a chief complaint of sinus congestion and runny nose that began 2 days ago. She tells you that her sinus infections always start off this way, and she has a wedding to go to this coming weekend and does not want to be sick for this event. She is requesting antibiotics and is quite insistent that she requires this treatment.

 

Past Medical History: Unremarkable. History of seasonal allergies and recurrent sinus infections. She does have some history of episodes of elevated blood pressure without a diagnosis of hypertension.

 

Family History: Noncontributory. No one else at home is sick.

 

ROS (completed by the medical assistant):

 

Constitutional: The patient denies fevers, chills, sweats, and weight changes.

 

EYES: The patient denies any visual symptoms.

 

EARS, NOSE, AND THROAT: No difficulties with hearing. Endorses sinus congestion and rhinitis.

 

Cardiovascular: Patient denies chest pains, palpitations, orthopnea, and paroxysmal nocturnal dyspnea.

 

RESPIRATORY: No dyspnea on exertion, no wheezing or cough.

 

GI: No nausea, vomiting, diarrhea, constipation, abdominal pain, hematochezia, or melena.

 

GU: No urinary hesitancy or dribbling. No nocturia or urinary frequency. No abnormal urethral discharge.

 

Musculoskeletal: No myalgias or arthralgias.

 

Neurologic: No chronic headaches, no seizures. The patient denies numbness, tingling, or weakness.

 

Complete the following:

 

Initial Post by Wednesday (Day 3) at 11:59 p.m.

 

List 10–20 additional questions of subjective information that you would need to elicit from your patient to help formulate your differential diagnoses and plan. You may not ask questions that were already addressed in the HPI/ROS. Make sure to watch the telehealth modules which include how to complete the physical exam via telehealth. You will need two scholarly references for the questions that you ask of your patient. See the rubric for more detail.

 

TIP | Watch the following videos on Telehealth:

 

Introduction to Conducting Physical Exams via Telehealth with Devices (1:51 Minutes)

 

Introduction to Conducting Physical Exams via Telehealth with Devices Video Transcript

 

Telehealth Physical Exam: ENT (9:10 Minutes)

 

Telehealth Physical Exam: ENT Video Transcript

 

Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:

 

Every peer post should only have one response post. Please do not reply to a peer if a response is already posted.

 

You are answering as the patient. Make it case appropriate but imaginative. Be creative and answer thoroughly. No references are needed.