Shizuoka Medical Center / Hawaii International Teaching Hospital
Clinical Reasoning PBL 'Jerrinar' Workshop
Gerald Stein, MD, FACP
July 28, 2023





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Dr. Stein’s archives 2021/02/21, 2021/06/24, 21/11/19, 22/01/26, 22/02/04, 22/06/17, 22/09/09 & 23/01/13
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Shizuoka Medical Center-JrSr Hawaii Medical Educational Program 2023-07-28

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Drs. Machi, Sugia-Beecroft, & Stein pose with presenter Dr Ofuka, staff at Shizuoka Medical Center & Tokyo Bay Medical Center residents starting Jerrinar
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Dr. Ofuka presents patient's history of acute progressive dyspnea symptoms leading to acute respiratory failure
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Drs Usami, Kaneko, Tomiyama, & Matsushita discuss patient's important data & grouping for early diagnosis of community acquired pneumonia(CAP)
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Drs Usami, Kaneko, Tomiyama, & Matsushita complete patient's important data & grouping of worksheet for understanding acute respiratory failure pneumonia
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Dr Stein explains grouping of important data from history and examination with early diagnosis of SIRS, Respiratory Failure & atypical pneumonia
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Dr. Usami questions patient need for HIV testing and reasons for stopping antibiotics when Dr. Ofuka diagnosed E-Cigarette Vaping Associated Lung Injury
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Dr Matsushita aska about risk factors for vaping pneumonia/ E-Cigarette Vaping Associated Lung Injury -EVALI & reason for popularity of vaping
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Dr Stein shows ToolBox2 complete many differential diagnoses, plan of studies & treatments with bullous emphysema added from chest CT
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Dr. Ofuka explains patient's hospial course with progressive improvement in CRP & SpO2, antibiotics(ABx) and prednisone
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Dr Stein emphasizes focused Review of Systems history questions for patients fever, dry cough, dyspnea, chest pain and darrhea
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Dr Stein answers Dr Usami's question reasons for stopping antibiotics(ABx): start antibiotics for CAP; when cultures negative & EVALI disgnosed, stop ABx
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Drs. Machi, Sugia-Beecroft, Ehara & Stein pose with presenter Dr. Ofuka and Tokyo Bay MC residents ending EVALI Jerrinar