Discovery CPC: Blood Is Thicker Than Water

In this Discovery Clinical Pathologic Conference (CPC), Dr. Karla Criner, Resident, Department of Medicine, presents the case of a previously healthy 18-year old male with a five month history of abdominal pain and growing distension. Dr. Courtney Miller-Chism, Assistant Professor, Department of Medicine, Section of Hematology-Oncology at Baylor College of Medicine, serves as the faculty discussant. She reviews the anatomy and physiology of the hepatic portal system and then develops a differential diagnosis to explain the patient’s ascites. 

As part of the Discovery CPC, Dr. Miller-Chism requests laboratory and imaging studies and explains her rationale for each request. She evaluates the lab results in the context of the patient’s history and physical exam findings.

Dr. Dhairyasheel Patel, Resident, Department of Radiology at Baylor College of Medicine, discusses the contrast-enhanced CT scan and abdominal ultrasound performed on the patient. He compares the patient’s imaging with normal imaging and highlights the relevant findings. 

CME Information

CME Credit Available

You may claim CME credit after watching this activity.

Needs Statement

Faculty and trainees within the Department of Medicine who are involved in the care of patients need to be regularly updated with the recent advances and guidelines in the fields of medicine and quality improvement to increase clinical knowledge. This Grand Rounds series also aims to provide learners with the appropriate skills to implement the advances and guidelines in clinical practice to enhance the quality of patient care and outcomes.

Objectives

At the conclusion of this activity, the participant should be able to:

  • Create a differential diagnosis for the clinical syndrome of acute abdominal pain and distension.
  • Discuss the laboratory and imaging diagnostic workup for acute abdominal pain and distension.
  • Delineate, from a hematology standpoint, clinical considerations in the presentation of abdominal pain and distension.

Target Audience

  • Physicians
  • Medical Students
  • Fellows
  • Residents
  • Nurses
  • Other Health Professionals

Accreditation/Credit Designation

Baylor College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Baylor College of Medicine designates this enduring material activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Program Director

Richard J. Hamill, M.D.
Professor
Department of Medicine
Baylor College of Medicine
Houston, Texas
Disclosure: Nothing to disclose.

Term of Approval

August 1, 2019 through August 31, 2021. Original release date: August 1, 2019.

Disclosure Policy

The Office of Continuing Medical Education (OCME) makes every effort to develop CME activities that are scientifically based, accurate, current, and objectively presented. In accordance with the Accreditation Council for Continuing Medical Education Standards for Commercial SupportSM, Baylor College of Medicine (BCM) has implemented a mechanism requiring everyone in a position to control the content of an educational activity (e.g., directors, planning committee members, contributors, peer reviewers) to disclose any relevant financial relationships with commercial interests (drug/device companies) and manage/resolve any conflicts of interest prior to the activity. Individuals must disclose to participants the existence or non-existence of financial relationships: 1) at the time of the activity or within 12 months prior; and 2) of their spouses/partners.

Baylor College of Medicine does not view the existence of interests or relationships with commercial entities as implying bias or decreasing the value of a presentation. It is up to the participants to determine whether the interests or relationships influence the presenter with regard to exposition or conclusions.

If at any time during this activity you feel that there has been commercial or promotional bias, please inform us by using the commercial bias comments box in the evaluation form. Please answer the questions about balance in the CME activity evaluation candidly.

Disclosures

The following individual(s) has/have reported financial or other relationship(s) with commercial entities whose products/services may relate to the educational content of this activity:

Presenters

  1. Karla Criner, M.D. Placeholder Image

    Karla Criner, M.D.

    Internal Medicine Resident
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  2. Courtney Miller-Chism, M.D.

    Courtney Miller-Chism, M.D.

    Assistant Professor
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

  3. Dhairyasheel Patel, M.D. Placeholder Image

    Dhairyasheel Patel, M.D.

    Radiology Resident
    Baylor College of Medicine

    Disclosure:

    Nothing to disclose.

CME Credit Available

You may claim CME credit after watching this activity.

View the CME Information Take the Post-Test Now

Presenters:

  1. Karla Criner, M.D. Placeholder Image

    Karla Criner, M.D.

    Internal Medicine Resident Baylor College of Medicine
  2. Courtney Miller-Chism, M.D.

    Courtney Miller-Chism, M.D.

    Assistant Professor Baylor College of Medicine
  3. Dhairyasheel Patel, M.D. Placeholder Image

    Dhairyasheel Patel, M.D.

    Radiology Resident Baylor College of Medicine