Is this patient high-risk?

A 55-year-old female presents with a low-grade fever, a new heart murmur, and Janeway lesions one week following a dental cleaning, and a preliminary diagnosis of infective endocarditis is made. Prophylactic antibiotics are administered prior to dental cleanings to prevent endocarditis in patients considered to be high-risk. Which of the following valvular conditions requires prophylactic antibiotics prior to dental cleanings?

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Internal Medicine: The "Classic" Physician

By Brent Schnipke

If the average reader is asked to imagine a typical medical student, he or she might picture the following scene: a group of frazzled young people in short white coats, scurrying around the wards of a large academic medical center. They travel in hordes, flocking to the nearest attending, who calmly asks them asinine questions and then chides them for their lack of knowledge. This scene is stereotypical of an often-stereotyped field, and might be something one would see in a caricature of the hospital – on a show such as Grey’s Anatomy or Scrubs. Although this is only one example of what medical education can look like, it is helpful for giving a simplified look at the life of a third-year medical student in the throes of clinical rotations.

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Dr. Sandeep Jauhar, Author of Doctored

sandeep jauhar

What made you decide to write your new book, Doctored? What were you hoping to accomplish?
When I was growing up, my mother wanted me to become a doctor. She told me, “I want people to stand when you walk into a room.” When I started my first job as a cardiologist, I realized I had been isolated from the changes occurring in medicine. I was a fellow in cardiology; I was learning about the human body, the heart, the physiology, and the therapeutics, but not about the culture of practice. I was shocked to see how unhappy many of my colleagues were. The unhappiness wasn’t just about paperwork, patients going on the Internet, malpractice, the usual things you hear about – it was a deeper, more existential problem. The problem was the systems of medicine didn’t allow them to be the kind of doctor they wanted to be – the same kind I wanted to be. When I entered medical school, I had this fantasy that I was going to reform the profession somehow. I didn’t know how, but I thought I would, somehow. When I got out, I started seeing physicians who were unhappy. I think their unhappiness was a response to this loss of ideals. I think a lot of physicians have had to compromise their ideals because of a diseased system. That’s why I wrote the book. I wanted to write about it and put it out there.

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20 Questions: Allan S. Stewart, MD: Cardiothoracic Surgery

Thoracic surgeon Dr. Allan S. Stewart is director of the aortic surgery program and co-director of the valve repair center at Mount Sinai Health System. Stewart received his bachelor’s degree in biology magna cum laude from St. Peters College (1991), and his MD from University of Medicine & Dentistry of New Jersey (1995). Dr. Stewart completed an internship and residency in general surgery at Hospital of the University of Pennsylvania. He completed a postdoctoral research fellowship in the division of cardiothoracic surgery/department of physiology at University of Pennsylvania School of Medicine, a chief residency in general surgery at Hospital of the University of Pennsylvania, and a residency in cardiothoracic surgery at Columbia University Medical Center. Lastly, he completed a fellowship in ventricular assistance at Columbia University Medical Center. Dr. Stewart is currently associate professor of cardiothoracic surgery at Icahn School of Medicine, Mount Sinai Health System.

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20 Questions: Sandeep Jauhar, MD

Dr . Sandeep Jauhar

 
Sandeep Jauhar, MD, director of the Heart Failure Program at Long Island Medical Center, is author of Intern: A Doctor’s Initiation. Dr. Jauhar’s route to medicine was not entirely direct, as he earned a bachelor’s degree (‘89), master’s degree (‘91) and PhD (‘95) in physics from the University of California, Berkeley, before graduating from Washington University School of Medicine (‘98).

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