@jakegoodmanmd - Dr. Jake Goodman 👨🏻‍⚕️ Profile

Thank you for the 🔥 couch Sabai! ad, more info in comments #sabai #couch #homeimprovement #gifted

WHITE HOUSE VLOG (Part 1) #doctor #healthcare #whitehouse

#POV You’re The Doctor (Neurology) #doctor #neurology #medicine #premed #medschool Answer: B – Huntington’s Disease. This patient most likely has Huntington’s Disease, a genetic movement disorder that causes a host of movement and mood changes. On MRI, you’ll see wasting of the caudate nucleus (part of the brain that helps regulate movement) that leads to large ventricles (black circles in the center of the image) 1. Early on, patients may show jerky, purposeless movements known as chorea (sometimes described as “dance-like”) 2. Later, patients may also show cognitive decline (dementia, personality changes, and namely severe depression). It’s important to keep in mind Huntington’s is both inherited and demonstrates anticipation, meaning those with the disease may show a worse degree of symptoms (and often sooner) than their parents. In Alzheimer’s, cognitive decline is more evident later (65+), and chorea movements would not be present. You’d also see more hippocampal atrophy compared to caudate atrophy on an MRI (Answer A). Parkinson’s movement will usually have subtle tremors at rest with rigidity making it hard for those patients to stand or walk at all (Answer C). *A note: While there are meds to help manage Huntington’s symptoms, there is no definitive treatment. These patients unfortunately have a poor prognosis, and it’s crucial to watch for signs of depression.

#POV You’re The Doctor (Pediatrics): Season 3, Episode 3 Answer: C - Call Child Protective Services - This is an example of Factitious Disorder (imposed on another, FDIA). Factitious Disorders occur when individuals willingly fabricate or even induce medical symptoms not for external but rather internal gain (sympathy, sense of purpose, etc). Previously known as Munchhausen by Proxy, FDIA specifically occurs when an individual imposes symptoms on another, most often seen in children or elderly, to obtain the “caregiver role”. While new-onset Diabetes may seem likely, typically kids would present with HIGH blood sugar and LOW insulin, not the opposite (answer A). Also, low levels of C-peptide indicate the patient’s insulinemia is exogenous not endogenous, suggesting he either took/was given too much insulin. With the mother’s continual concern after the patient’s improvement (answer B, MRI could be considered with lack of improvement or additional signs of mass involvement) as well as her mention of her own Diabetes, the picture put together suggests it’s likely she gave her child her own insulin!  - When suspicious of FDIA, it is important to make sure the imposed individual is medically stable. After, providers should make sure to get CPS (or DCF) involved (ALL MEDICAL PROVIDERS HAVE A DUTY TO WARN), then separate patient from the perpetrator, and with an additional team member present, discuss your concerns with the perpetrator in an unthreatening, supportive manner (as long the situation is safe to do so). If the perpetrator is engaging and willing, they should next be referred to mental health services for routine psychotherapy. - *Remember, it’s not the child but rather the mother (perpetrator) in this case who would be diagnosed! Reference: 1. “Factitious Disorder (Munchausen Syndrome by Proxy): What Is It & Symptoms.” Cleveland Clinic #doctor #pediatrics #medicine #healthcare #medschool #premed #medstudent #jakegoodman Disclaimer: My content is for educational and marketing purposes and should not be used in place of therapy or treatment

DOCTOR vs. DOCTOR Quiz, #FableticsAmbassador Internal Medicine took the W today over Psychiatry but this isn’t over. I’ll be back. As you can tell, Ari loved winning a new pair of @fableticsscrubs . We’ve been wearing Fabletics to the hospital daily, and we love how comfortable and functional they are. To purchase a pair for yourself, head to my page link. #doctor #fabletics #scrubs #resident #medschool #healthcare

#POV You’re The Doctor (Neurology): Season 3, Episode 2. ANSWER BELOW Answer: B – Narcolepsy The patient most likely has developed Narcolepsy, a neuro disorder that causes a host of fatigue related symptoms. It usually pops up first in adolescence, but it can also come later in life as seen here. Patients with narcolepsy will show excess daytime sleepiness even with sufficient sleep, and it often occurs during inappropriate times (like working a crane). They may also find themselves suddenly weak in an arm or leg (cataplexy) or even with strange hallucinations as they’re falling asleep (hypnagogic hallucinations) as seen in this patient who sees ghosts as he’s falling asleep! While daily exertion in a physically demanding job can cause fatigue, this patient appears to get enough sleep each night to recover, and it also wouldn’t explain the hallucinations (Answer A). A brain tumor, which can cause fatigue and altering levels of consciousness, would most likely also produce headaches, visual/focal deficits, or even behavior changes (Answer C).  References: Kim LJ, Coelho FM, Hirotsu C, et al. Frequencies and associations of narcolepsy-related symptoms: a cross-sectional study. J Clin Sleep Med. 2015; 11(12): p.1377-1384.

5 Things I Would Never Do As A… #Doctor #medschool #medicine #healthcare #psychiatry @MedFluencers

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#POV You’re The Doctor (Dermatology/Psychiatry): Season 3, Episode 4. Follow for the next episode 🙏🏼 Answer: C – CBT.  This young girl with a repetitive history of hair loss around her crown and eyebrows is suggestive of Trichotillomania – a compulsive hair-pulling disorder! In the same family of OCD, Trichotillomania is characterized by repetitive hairpulling of the scalp, eyebrows, and eyelashes, resulting in differing length spots of baldness (a shorter area being from a recent episode of pulling compared to a longer). The episodes tend to be around times of stress or anxiety, in her case when she has a big game coming up, as a habit. Allergens, while unlikely to cause significant hair loss, would still show even length patches (A). While thoughts of parasites or fungi should be considered in a school-aged patient, they would most likely result in significant itching and there would likely be reports of others in the class/team with similar symptoms (B). Trichotillomania is treatable! The best treatment for Trichotillomania is a combination of antidepressants and cognitive therapy1. As this patient has already takes medications for her depression, the best next step would be to suggest starting cognitive behavioral therapy (CBT) to start practicing habit reversal before permanent damage to the hair starts! References: Öst LG, Havnen A, Hansen B, Kvale G. Cognitive behavioral treatments of obsessive-compulsive disorder. A systematic review and meta-analysis of studies published 1993-2014.. Clin Psychol Rev. 2015; 40: p.156-69. #doctor #dermatology #psychiatry #doctor #medicine #healthcare #medschool #premed #medstudent #jakegoodman