How to Write an Abstract &

Make a Great Poster!

Carlos E. Nolasco M., M.D.
Assistant Professor of Clinical Internal Medicine
SIU School of Medicine

Objective
For the residents involved in the IM Scholarly Club
(and ideally all IM residents) to submit at least one
abstract to ACP for the ACP Downstate IL Chapter
meeting.

Overview
Writing an Abstract (sections)
Types of Posters and Poster Construction.

Research Poster
Case Presentation Poster
Quality Improvement Poster
Patient Safety Poster

Examples
Presentation
Judging/Evaluation

Overview
Writing an Abstract (parts)
Types of Posters and Poster Construction.

Research Poster
Case Presentation Poster
Quality Improvement Poster
Patient Safety Poster

Examples
Presentation
Judging/Evaluation

Why to do it?
Whats the purpose?
This is a way to communicate research
To represent yourself and your work to peers
and colleagues
To network with leaders in your field of
interest
To improve your CV and presentation skills

Is it worth it?
Consider presenting a case:
Increase AWARENESS OF A (NEW) CONDITION
UNUSUAL PRESENTATION of a relatively common
condition
Suggests the PROPER DIAGNOSTIC STRATEGY
UNUSUAL COMPLICATION of a disease and its
management
ABOUT THE MESSAGE OR LESSON that the case
can deliver

Abstract
An abstract is a brief summary of a research
article, a thesis, clinical case, etc. that quickly
allows the reader to learn the purpose and its
main points.
Abstracts are used as the basis for selecting
research proposed for presentation.

Abstract (cont..)
Abstract will form the body of your poster.

You will take an already concise description

of your work (abstract) and transition it into
an exciting, interesting, accurate work of art
(poster)!!!

Abstract (cont)
Dont worry, they are easy to do

Sections of an Abstract
Short, descriptive, interesting TITLE.
AUTHORS NAME and affiliation.
Short INTRODUCTION that explains the relevance
of the case.
CASE DESCRIPTION is sequenced in the order of
history, physical, investigations, and course.
The DISCUSSION emphasizes the lessons of the
case

Short, descriptive, interesting title

Authors name and

affiliation

Case description is
sequenced in the
order of history,
physical,
investigations, and
course

The discussion
emphasizes the
lessons of the case

Ergotism Masquerading as Arteritis

Amy Tarnower, Associate, Department of Medicine, Michigan State
University, East Lansing MI.
Ergotism is a condition characterized by intense generalized
vasoconstriction. The infrequency with which it is encountered makes
ergot poisoning a formidable diagnostic challenge.
A 34-year-old woman consulted her doctor because of headaches,
dyspnea, and burning leg pain. A clinical diagnosis of mitral stenosis was
made. Within a month, she had a cardiac catheterization because of
progressive dyspnea. At catheterization, severe mitral stenosis was
confirmed and an elective mitral value commisurotomy was scheduled.
She presented to the hospital one day early because of increased burning
in her feet and new onset right leg pain. In addition to mitral stenosis, the
physical examination revealed a cool, pulseless right leg. An arteriogram
showed subtotal stenosis and a pseudoaneurysm of the popliteal artery.
At the time of the commisurotomy, a right femoral artery balloon dilation
followed by patch graft repair of the stenosis was performed. On the fifth
postoperative day, she experienced a return of the burning leg pain and
the leg was again found to be cool and pulseless. An emergency
arteriogram showed smooth segmental narrowing and bilateral
vasospasm suggestive of severe, generalized large-vessel arteritis.
Treatment was initiated with high-dose corticosteroids, anticoagulants,
antiplatelet drugs, and vasodilators. Despite this, her condition worsened,
with both legs becoming cool and pulseless. Additional history revealed
that she had been abusing ergotamine preparations for a number of years
to relieve chronic headache symptoms, and she continued to receive
these medications during hospitalization. At this point, the ergotamine
preparations were discontinued and an intravenous infusion of
nitroprusside was begun, resulting in signif icant improvement within 2
hours and her symptoms completely resolved within 24 hours. The
patient remained symptom-free after the nitroprusside was discontinued
and was discharged from the hospital.
This case illustrates the potential for severe vascular ischemia with use of
ergotamine and the value of a complete history. Although the ischemia
seen in this patient is rare, it was a predictable side effect of ergotamine
use. Recognition of this syndrome is critical to institution of appropriate
therapy and prevention of ischemic necrosis of an extremity.

Abstract fits inside the box

Short introduction that

explains the relevance
of the case

Four C's of Abstract Writing

Complete it covers the major parts of the project/
case
Concise it contains no excess wordiness or
unnecessary information.
Clear it is readable, well organized, and not too
jargon-laden.
Cohesive it flows smoothly between the parts.

Title: Examples
Seronegative autoimmune hepatitis presenting with acute
hepatitis and severe asymptomatic hyperbilirubinemia
Subdural empyema, cerebral edema and intracranial sepsis
due to Streptococcus vidirans after an ear infection in a 38 year
old male with no co-morbidities
A rare cause of renal cancer and SIADH: diffuse large B cell
lymphoma
Paraneoplastic Cerebellar Degeneration: a case of ataxia
leading to the diagnosis of Hodgkins Lymphoma. Tr Antibody
Syndrome?
Erythrocytosis and polycythemia after dasatanib therapy

Funny Titles
Release the Kraken: when the immune system
awakens
Against all odds - mid aortic dysplastic syndrome
presenting with heart failure-like symptoms in the 6th
decade of life
What Infarcted My Kidney?

Introduction
Define the issue, establish the purpose, justify your
work/case, (provide a clear hypothesis)

Fulminant hepatic failure is a rare presentation of

Wilsons disease, which if unrecognized carries a
high mortality rate without liver transplantation.

Case Presentation
HPI
Relevant Hx
Physical examination
Labs/imaging/other investigative studies
Clinical course and outcome

It has to flow!!!!

Discussion
The discussion should evaluate the patient case for:
Accuracy, validity, and UNIQUENESS.
Compare and contrast the case report with the
published literature.
Why decisions were made and extract the lesson from
the case.

Sections of an Abstract
Short, descriptive, interesting TITLE.
AUTHORS NAME and affiliation.
Short INTRODUCTION that explains the relevance of the case.
CASE DESCRIPTION is sequenced in the order of history, physical, investigations,
and course.
The DISCUSSION emphasizes the lessons of the case

CONCLUSION: two lines.

Research Abstract
Title
Author(s) information
Introduction
Methods
Results
Conclusion

Patient Safety & Quality

Improvement Abstract

Title
Author(s) Information
Introduction
Methods
Results
Conclusion

Category focusing on improving patient safety,

quality & evaluating patient satisfaction.

Remember
Summarize! Summarize! Summarize!
Do not leave potential connections or important
information out

< 450 words (for ACP)

Check your grammar

Challenge
Deciding if work is worth entering

Please, dont sleep!...

Now,
From this

to this.

Poster Creation
Powerpoint or Keynote
Use a single slide
Easy to read/follow
Attract viewers attention
Communicate results of investigation effectively

Poster Creation (cont)

A single single on PowerPoint...
Set size of single slide (not to exceed 46 inches X 46
inches)
Use large font for text
Check poster in zoom view to see true arrangement

Some considerations
Use a template
Play with background, box/text sizes, format,
images, color
Word count, prose style, grammar, fluidity, figure
clarity, spelling, aesthetic appeal
Create a draft before the conference

Poster Arrangement
Timing:
Viewer able to glean message in 35 minutes
Viewer able to read text in 10 minutes

Cook County Hospital

John H. Stroger, Jr. Hospital of
Cook County
Department of Medicine1
Division of Hematology-Oncology2

Description of Cases
Case #1 (X):
A 62-year-old male with stage IIIB poorly differentiated
non-small cell carcinoma of the left lung status post
chemotherapy and radiotherapy presented with 5-day
history of diplopia not associated with headache,
nausea, vomiting or focal neurological deficits.
Examination was remarkable for isolated left VIth
cranial nerve palsy. Head CT showed a
hyperenhancing mass posterior to the sphenoid sinus
eroding the clivus. MRI confirmed the presence of a
metastatic tumor in the left side of clivus and left
petrous bone. Patient was started on steroids and
completed 10 sessions of WBRT. Diplopia improved
with therapy. Unfortunately, he expired two months after
diagnosis from progressive disease.

Carlos Nolasco, MD1; Shweta Gupta, MD2

Causes of VIth Nerve Paralysis

Introduction
Ophtalmoplegia secondary to sixth nerve paresis as a
result of malignancy was first reported by Godtfredsen
in 1947. At the time, this finding was seen in
association with nasopharyngeal cancers and he
concluded that concurrent paresis of sixth and twelfth
cranial nerves was pathognomonic of these tumors. It
has now been reported that this pattern can occur in
other primary and metastatic neoplasms, though it
continues to be rare.

A Curious Physical Examination Finding:

VIth Cranial Nerve Palsy as a Sign of Clival Involvement
in Cancer Patients

VASCULOPATHIC

NON-VASCULOPATHIC

Diabetes

Sarcoidosis

Hypertension

Increased ICP

Discussion
The clivus is the bony surface in the base of the skull
formed by the anterior portion of the occipital bone at
its junction with the sphenoid bone.

The mechanisms by which malignant clival lesions

produce VIth and XIIth nerve dysfunction are still not
fully elucidated, but could involve direct invasion from
Intracranial aneurysms
Chiari malformation (children) the tumor (VIth nerve) and retropharyngeal lymph node
metastasis (XIIth nerve). Cancers known to cause
Others: Idiopathic, Trauma
Malignancy
these lesions include: nasopharyngeal carcinomas,
lymphomas, chordomas, meningiomas, squamous cell
Physical Examination
carcinomas, adenocarcinomas, multiple myelomas,
A) At Rest B) to Left C) to Right Protruding Tongue (XIIth palsy) gastrointestinal stromal tumors, hepatocellular
carcinomas, malignant melanomas, prostate cancers,
breast cancers, and others.
A
Although clival metastases are rare (0.18% of all
intracranial tumors and 0.42% of skull base tumors),
sixth nerve paresis is frequently the first sign of a clival
mass. These cases along with others reported in the
B
literature highlight the importance of considering
malignant clival involvement and, possibly, occult
metastatic disease when a patients physical
examination reveals new VIth cranial nerve palsy,
especially if presented concurrently with XIIth nerve
C
*Please note associated
paresis.
tongue atrophy on the right

Atherosclerosis

Multiple sclerosis

Vasculitis (e.g. GCA)

Stroke (usually not isolated)

Imaging

Case #2 (Y):
A 48-year-old female with 2-year history of multiple
myeloma was admitted for right leg edema and pain
secondary to osseous lesions in the distal femur and
X
proximal tibia. She was discharged and seen in clinic
where she was noted to have hypercalcemia and was
readmitted. At the time, she also complained of
headache and 2-day history of diplopia and blurry
vision. Physical examination was remarkable for new
right VIth and XIIth nerve palsies. MRI of the brain
revealed a destructive lesion with abnormal bone
marrow replacement involving the clivus and sphenoid
bone. Infiltrating lesions from C1 to C4 were also
visualized. She was started on steroids and completed Y
10 sessions of WBRT; however her diplopia did not
improve. She was referred to an outside facility for stem
cell transplant.

Bibliography
1: Pallini R. et at. Clivus metastases: Report of seven patients and literature
review. Acta Neurochir (2009) 151:291296. Review.
2: Ulubas B. et at. Clivus metastasis of squamous cell carcinoma: a rare location.
Journal of Clinical Neuroscience (2005) 12(1), 9798.
3: Thapa L. et at. Eye twist and tongue twist: a rare neurological syndrome. MJ
Case Reports 2011; doi:10.1136/bcr.06.2011.4366.
4: Ki Baeg M. et at. Diplopia as a Presenting Symptom in a Gastric
Gastrointestinal Stromal Tumor. Jpn J Clin Oncol 2011;41(2)265268.
5: Keane JR. Combined VIth and XIIth cranial nerve palsies: A clival syndrome.
Neurology. 2000 Apr 11;54(7):1540-1. Pubmed ID PMID: 10751279.

AGAINST ALL ODDS THE DILLIGENT PHYSICAL EXAMINATION AND A CASE

CONGENITAL
Chronic(headache(can(be(a(diagnos/c(pain(in(the(head!(
OF
MIDDLE AORTIC SYNDROME DIAGNOSED IN 6TH DECADE

Ali, Muhammad Chua, Jacquelin Nolasco, Carlos Tchernodrinski, Stefan

Department of Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago
Because of
the clinical findings of aortic
obstruction but no coarctation seen previously,
we obtained CT chest (Figures 2.3.4) which
showed marked narrowing of descending aorta.
TTE redemonstrated the aortic narrowing
(Figure 1); Diagnostic cardiac catheterization
revealed normal coronaries; peak-to-peak
pressure gradient across the aortic lesion was
55 mm Hg.

Introduction
Middle Aortic Syndrome (MAS) is a rare
condition, with only 200 cases described in the
literature; of these, aortic hypoplasia is among
the rarest causes of MAS.

Case Presentation
History: A 58 year old Hispanic woman was
admitted with two months of progressive
dyspnea on exertion. Her past medical history
was significant for resistant hypertension. Prior
work up including plasma aldosterone to renin
activity ratio, plasma and urine metanephrines,
24-hour urine free cortisol and catecholamines,
thyroid function tests and bilateral renal artery
doppler ultrasound; had all been unremarkable.
Transthoracic echocardiogram (TTE) one year
prior, showed ejection fraction of 60% and
grade 2 diastolic dysfunction.

Figure'1'

Figure'2'

The patient underwent

thoracotomy, which
showed severe hypoplasia of the descending
aorta starting approximately 6 cm distal to left
subclavian artery to just above the level of
diaphragm. Aortic replacement was performed
with Dacron graft. Histopathologic exam of
resected aorta revealed atherosclerotic plaque
(60% occlusion); and moderate intimal fibrosis.
Elastin stain showed focal fragmentation of
medial elastic tissue, associated with focal
thinning and fibrosis.
Currently the patient is well and has excellent
BP control and significant improvement in her
exercise tolerance.

Examination: BP in arms was 210/70.

Holosystolic murmur was audible on anterior
and posterior chest. Lower extremity pulses
were diminished, with radio femoral delay.

Conclusion

BP was then measured in lower extremities and

revealed a difference of 70 mmHg from upper
extremities.

This case illustrates the importance of a

thorough physical exam, which in this case
directed the appropriate investigations and
treatment just by a simple maneuver, regrettably
rarely performed these days checking for
pulses and BP difference between different
extremities.

Investigations: BNP 172 pg/ml. chest X-ray

showed cardiomegaly, interstitial changes and
cephalization of pulmonary vasculature.

Disease Course
The patient was initially managed for heart
failure with preserved ejection fraction and
responded well to intravenous furosemide and
BP control.

Figure'3'

Figure'4'

Surprisingly, the cause of this patients aortic

obstruction was congenital MAS. This
uncommon condition can rarely go undetected
till late adulthood. Without corrective surgery,
the mortality is high, with an estimated average
length of life of 30 years. To our knowledge this
is the third reported case diagnosed in the 6th
decade.

Tips
Title: 2 lines or less
Intro: define the issue, establish the purpose, justify your work/
case, (provide a clear hypothesis)
Case presentation: HPI, relevant hx, labs/imaging/studies,
hospital course
Discussion: remind the viewer of the hypothesis/case, discuss if/
why results were conclusive, point out relevance of findings to
other published work, Discuss limitations of the work, Highlight
future directions of the research
Conclusion: 2 sentences, a concise summary
References/acknowledgments

Before finalizing
Get help from a mentor
Make revisions based upon the feedback
Have others read your draft in order to check for
technical errors, such as spelling and grammar
mistakes

Tips
Where to send the poster to:
http://www.makesigns.com/

Know the rules for the posters!!

Changing gears

Judging criteria
Clinical Vignette Abstract

Research Abstract

Judging (cont)
Originality
Case Presentation
Methodology
Visual Impact
Interview (presentation)

Clinical Vignette Abstract Checklist

q Due date for abstract is ____________.
q Number of copies needed ____________.
q Presenting author is listed as first author.
q Presenting author meets eligibility requirements for the meeting.
q Author affiliations are listed.
q Abstract clearly organized into Introduction, Case Description, and Discussion.
q The lesson of the case is presented clearly and concisely.
q Completed abstract meets word- limit requirements or fits into formatting box.
q Abstract printed with correct font size and style (if stipulated).
q Others have reviewed abstract for content, style, grammar, and spelling.
q Mail abstract to:

Lastly, when presenting

Prepare to give a 2 to 5 minute outline of your
poster.
Speak calmly and clearly.
Dont be afraid!!!
Be ready to go through the whole thing in detail.
One or two people may want to know everything!

Thanks! And Good Luck!!