FMPC 5000

Family Medicine Clerkship - Ultrasound

Introduction

The Family Medicine Clerkship Ultrasound requirements aim to provide clinically relevant education on how to use point-of-care ultrasound (POCUS) during your Family Medicine clerkship. The ultrasound requirements are designed to give you a deeper understanding of some of the concepts taught during the clerkship through the experience of ultrasound.

Ultrasound at the bedside to screen the aorta for abdominal aortic aneurysms and to scan the IVC for fluid status are ultrasound exams that are used often in the office and hospital settings for Family Medicine patients . Since these ultrasound imaging views are so frequently performed, we want our medical students to be proficient at this exam as they move through this clerkship.

QUICK LINKS:

MCG CO2025 CLERKSHIP ULTRASOUND REQUIREMENT INSTRUCTION VIDEO   Email Ultrasound Image Link   FAQ

Educational Ultrasound Informed Patient Consent   FMPC US Image and Case Info Upload Link   

 

HOW TO DOWNLOAD IMAGES FROM MACHINES OTHER THAN LUMIFY 

Philips Sparq    Sonosite     GE    Cart-Based Ultrasound

LEARNING OBJECTIVES

At the end of this module, you will be able to:

• Acquire aorta ultrasound views to screen for abdominal aortic aneurysm and an IVC view to document fluid status with limited assistance.
• Interpret the findings of aorta and IVC ultrasound images on actual patients and mock case scenarios. 
• Integrate the findings of aorta and IVC ultrasound images in the care plan of actual patients and mock case scenarios.

Abdominal Vascular Anatomy    Abdominal Aortic Aneurysm 

TO DO

Complete the following quizzes (includes patient consent attestation, image upload, and mock case scenario questions) prior to the end of your Family Medicine clerkship rotation by submitting 3 separate quizzes in this D2L course by the noted due dates.

Quiz 1       Quiz 2        Quiz 3

You will receive feedback on your images by email after they are graded. Quizzes must be completed by due dates.

 

WHAT DOES THE FAMILY MEDICINE CLERKSHIP ULTRASOUND IMAGE REQUIREMENT INCLUDE?

The Family Medicine Clerkship Ultrasound requirement consists of acquiring aorta and IVC images as follows: 

• The aorta should be imaged at the proximal, mid, and distal segments and the anterior to posterior diameter measured.
• The IVC image includes a longitudinal view of the IVC, liver, hepatic vein, and right atrium.

WHAT SHOULD THE IMAGES FOR THE FAMILY MEDICINE CLERKSHIP ULTRASOUND REQUIREMENT LOOK LIKE?

WHY AND HOW DO I COLLECT THE IMAGES FOR THE ABDOMINAL AORTIC ANEURSYM SCREENING EXAM?

• Why do we do screening exams? Many pathologic conditions are easier to treat when found early in the course of the disease. Arterial vascular diseases, particularly Abdominal Aortic Aneurysms (AAA), are one such disease. In fact, ruptured AAA is the 13th most common cause of death in the US.
• Why do we screen for AAA? Many factors but predominately atherosclerotic disease can cause the wall of the aorta to weaken and bulge (aneurysm). The risk of rupture increases exponentially with increasing diameter, making it important to find these aneurysms early in the course so that they can be safely repaired. However, many people do not get screened even though there are very clear screening guidelines (USPSTF Aortic Aneurysm Screening Guidelines). Some studies have documented the screening rate as low as 36% of those needing a screening ultrasound exam versus patients that actually obtain one. 
• How do we screen for AAA? Screening for AAA involves using ultrasound to measure the aorta diameter. This is easily done at the bedside using a portable ultrasound system. The Family Medicine clerkship assignment is designed so you can have hands-on practice performing a non-invasive screening exam. 
• Who do we screen? It is important to perform the screening exam on those patients at risk for AAA. The USPSTF recommends 1 time screening for AAA in men aged 65-75 years who have ever smoked. A secondary recommendation is that men 65-75 years who have never smoked be selectively offered screening. This recommendation should be based on the individual using their medical and family history and other risk factors and personal values. It is unclear if women aged 65-75 years who have smoked should be screened for AAA, but during the clerkship these are appropriate patients to screen. 
• Why do I also need to obtain a video / image of the IVC? The IVC is often confused with the aorta on ultrasound imaging. Evaluation of the IVC is included in the Family Medicine Clerkship to help you understand the anatomical differences in the IVC and aorta and to assure you do not mistake the IVC for the aorta during your AAA screening exam. 

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