Social Media and Online Professionalism Integrated into Year 3 OB/GYN Clerkship.

A curriculum-integrated course developed and taught by Library faculty was introduced into the Library's undergraduate medical education (UME) informatics longitudinal theme in 2014 to address growing concerns about the role of social media in medicine. Literature, social media content, and case-based discussion were used to meet educational objectives and facilitate interactivity. Most students indicated that their online behaviors would change as a result of the class. They became alert to potential negative and positive effects of social media use in their professional and personal lives. Since implementation, the curriculum has expanded within UME and graduate studies programs.

Unexplained persistent postpartum palpitations and tachycardia due to Group A Streptococcus.

BACKGROUND: Group A Streptococcus is one of the most morbid infections in modern obstetric practice. Pregnant women are known to have a 20-fold increased risk of invasive Group A Streptococcus with greatest risk in the first 4 days postpartum. The overwhelming majority of these infections will present with fever, uterine tenderness, or vaginal discharge. A much smaller subset may present to the Emergency Room after initial hospital discharge with much less obvious symptoms. In our case, persistent palpitations with unexplained tachycardia led to improper diagnosis in multiple Emergency Rooms. CASE PRESENTATION: A 37 year-old Caucasian female presents with four post-partum days of unexplained sinus tachycardia and absence of fever, uterine tenderness, or vaginal discharge, which elicits an extensive cardiac and pulmonary workup in multiple Emergency Rooms. Consequent late diagnosis of invasive Group A Streptococcus infection lead to significantly increased morbidity including toxic shock syndrome, acute renal failure, total abdominal hysterectomy and bilateral salpingo-oophorectomy, multiple laparotomies, fasciotomy, intubation, continuous renal replacement therapy, and extensive hospital course and recovery. CONCLUSION: Persistent palpitations with unexplained tachycardia in the post-partum patient in the Emergency Room setting is a potential early warning of Group A Streptococcus infection. Even in the absence of reported clinical fever, uterine tenderness, or vaginal discharge, an early speculum and pelvic exam, with or without consultation with the obstetrics service, is prudent due to the potentially high morbidity or even fatality of Group A Streptococcus infection.