CLIN EP PRESENTATIONS by 🐱

PRESENTATION 1
OB CASE

Second trimester = 16 weeks

2 weeks before consult = 11 weeks
Hpn isi chronic = before pregnancy of before 20 wks of gestation
Tight bp cocntrol (defiinition)

CLINICAL QUESTION 1 TREATMENT

Research Strategy: Tight control AND Hypertension AND Pregnancy loss
(intteruption) - comments:
DRIP:
clinical question
no bolean operator???
click
press see all
<summary text>
CUEVAS: submit clear copy of the search
The group equated the outcome to pregnancy loss. Is pregnancy loss a fetal or
maternal outcome? more of a fetal outcome cos fetal death. Pero pwede din na
maternal outcome cos pwedeng magkaron ng complication sa mother health wise s/a
prolonged bleeding etc. (gy)
 If you are looking for maternal outcome... *choppy*
Initial search = all the stuff in your prescription should be seen sa search (may
tight control pero walang search about the less tight control)
Important to report why you choose the article compared dun sa ibang
searches!!!
(may sinasabi syang something about RCT but hindi ko narinig. Gusto ata nya
ilagay yung study design sa search? *choppy*)
SISON:
Explain why the other atricles were not chosen. Explain also why you didnt
choose the others. Yung gusto ata nila is you have other slides or kahit yung titles man
lang nung iba para claro why di sila pwede.
(Mukhang gusto nila yung article number 3. yung "less tight verus tight control
of hpn in pregnancy" ok para safe ilagay mo na din yung objective nung mga rejected
artciles mo)
DRIP: decide a treatment question (pwede siguro kasi rct tong article); wag yung
"adjusting" cos tunog confounders yun.
o: adjustment of something
e: occurence of severe hypertension

CLINICAL QUESTION 2 PROGNOSIS

variable = exposure
22 resuults

Keywords Pregnant AND Chronic Hypertension AND Diabetes Mellitus

Wendy discussed the results of the article

(Interruption)
DRIP: Gusto lang nya malaman kung bakit relevant yung article. Wag mo idiscuss. Bakit
yan yung pinili mo. Convince him that that article is the relevant article and not the
other searches
Okay na nilagay nya yung title ng article cos dun pa lang pwede na nya malaman kung
relevant yun or hindi
● Does it address a prognosis question?

● Does it address your prognosis factor of interest?

SISON: 22 searches. Pano mo nadisregard the others and bakit yan yung pinili mo. Yun
yung gusto ko malaman. It doesnt mean na if the subj are pregnant and hypertensive
yan na yung tamang article.
CUEVAS: 2 WKS duration na yung hpn. Tapos 2nd trimester na yung px (4-6months).
Why did you identify this as chronic hypertension eh 2 weeks pa lang? (Definition sa ob
is before 20 weeks is chronic na)
Risk for type 2 diabetes and not gestational diabetes yung dapat na hinahanap nyo.
DRIP: write new slides na you could project (answers sa questions namin) so that
everybody is on the same page

_. Why this artcile???

SISON: *agit* rundown lang yung gusto ko marinig
WENDY: ito nga lang yung relevant
SISON: 22 yung searches mo. Umabot kayo sa tatlo! Bakit di na yun
kasali
DRIP: Can you comment about the 21 other artciles?
WENDY: Hindi nga relevant
DRIP: Better if alam mo lahat (but medj sane enough sya to understand
na hindi possible na alam mo lahat lol weird ni sison)

*drip starts writing shit* (ito daw yung clinical question summary nung
kay na wendy)
p- pregnant
e- chronic htn
o - dm

Yung sa article hindi match sa clinical question nila kaya nagagalit si drip

P
E - HX HOP HX GDM
O - HTN T2D

SISON: we dont want a subset of gdm kasi hpn disorder lang yung
tinitingnan natin. ang daming subj na hindi lang chronic hpn. madaming
mga other comorbids yung mga searches nyo
 3rd question: there are 2 independent var chronic hpn and gdm.
dependent var cvd and type 2 dm. focus is the developnent of type 2
cos of chronic hpn (????????????)

sison drip cuvas: we dont accept your ariticle 🙊 🙊 🙊 🙊 🙊

GOLDEN RULE:
🔑 DONT INTERRUPT SI DRIP
🔑 CONSULTATION IS GO TO FACI AND NOT SUBMIT SA ELEAP
🔑 YOU MAY CONSULT DRIP COS SUPERVISOR SYA 😎 (better to cos sya naman
yung pinaka-may say dito)

PRESENTATION 2 - ESCANO-GATCHALLIAN
MED CASE

CLINICAL QUESTION 1 TREATMENT

DRIP:
All of the search terms that represent all parts of the clinical question that you made
Justify the outcome of CLINICAL STABILITY
 Ang gusto lang nya is kayo mismo yung nakaisip. Ayaw nya na working back kayo.
Yung nakita nyo yung artcile tapos dudn kayo nagformulate ng question. Dont do this.

Why did you not include the elderly in the description?

We focused more on px with pneumonia since the study that was targeted was
treatment.
DRIP: when ur doing the educational prescription you are trying to summarize the
characterestics of your patient. You could write as many as you think would be relevant
later but when you do your search strategy... you choose one lang muna sa part ng
clinical questions. Pero put sa back of ur mind yung other characcterestic of your
patient. Put all char sa educational prescription. If you want to broaden or narrow... drop
the least important terms. Just allowing for the fact that the artciles may not be indexed
sa descriptor na yun.

CUEVAS: Yung clinical questoon is a whether you will add an additional what??? Why
did you accept this artcile when this artcile is a non inferiority not a superiority? If you
read the case scenario the sfx is addressed to the adidition of azirhromycin. Kayo yung
side effects yung inaaddress nyo. In the case scenario may danger na more sfx with
azithromycin. The non inferiority in the case study between beta lactam and beta
lactam azithromycin conbination is a non inferiority of the combination and not the beta
lactam alone? Main idea of adding another drug in the treatment is because it has a
superior or a better effect. Yun yung acceptable scenario. More expense better
outcome. Kung more expense similar or poorer outcome... its not acceptable ina.
Clinical sense.

Treatment is chosen if... (by DRIP) = plus points na yung reason nila for choosing was
not "bec this is the only artcile we found" but bec of 1 and 2
1. Benefit t > c
2. Benefit t = c, harm not increased
*propsed new treatment must be superior to the standard
*first hurdle ii the proposal of a new drug =new benefit, harm is decreased or superior
to the standard

*It was the only artcile we found" < very strong argument daw pala na it was the only
artcile we found. Dapat nagdrop na lang isang term para hindi lang 1 lang yung
lumabas. Para mapakita mo pa din na yun talag ayung best

Be honest na lang daw and say na hindi kayo nakapagprepare. Ayaw daw nya na sa
class nyo hinahanap yung sagot.

CLINICAL QUESTION 2 PROGNOSIS

Initial search nila is hospitalization lang so 33926 (mali to kasi nga kaylangan mo ilagay
lahat bago ka mag bolean) > 15 searches na lang pagka-bolean nila

++ pts kay claude cos he has all 15 article daw lol (sa 15 how many included dementia
as one of the variable and bakit hindi nyo yun pinili)