Case Presentation: A 78-year-old man with a history of paraplegia secondary to spinal stenosis, who presented with worsening dyspnea, fatigue, and confusion. On presentation, he was tachypneic and hypoxic, requiring 4 liters of oxygen via nasal cannula.Initial imaging revealed a large left pleural effusion with significant left lung atelectasis, a moderate right pleural effusion, and [...]

Case Presentation: A 70-year-old male with a past medical history of nephrotic syndrome secondary to anti-phospholipase A2 receptor (anti-PLA2R) associated membranous nephropathy presented with acute, progressive dyspnea. Exam was notable for pallor and his admission hemoglobin was 4.8. Initial labs also showed WBC 2.9, platelets 104, LDH 724, ferritin 2,215, Creatinine 1.8. Blood smear remarkable [...]

Case Presentation: A 67-year-old woman with a history of cocaine use presented with six weeks of progressive bilateral upper and lower extremity weakness, burning pain, and difficulty ambulating. Exam was significant for low grade fever and decreased sensation to pinprick in a stocking-glove distribution in all extremities. Muscle strength was reduced in the distal upper [...]

Case Presentation: A 51-year-old female with a history of lumbar stenosis (status post-transforaminal epidural steroid injection), hypertension, and migraines presented with altered mental status and severe acute headache. The day before, she experienced unusual lower back pain and, after consuming shrimp scampi, developed abdominal pain, nausea, flaccidity in her upper extremities, dysarthria, and a severe [...]

Case Presentation: A 66-year-old male with history of intravenous (IV) drug abuse presented with acute onset substernal chest pain and shortness of breath for one day. Initial EKG showed diffuse ST-elevations. Urine toxicology screen was positive for cocaine, cannabinoids, and fentanyl. CXR showed a hilar mass, which on CT showed a right upper lobe nodule [...]

Case Presentation: Patient is a 74-year-old male with type 2 diabetes complicated by neuropathy, lumbar spinal stenosis with radiculopathy, and venous insufficiency who presented to the ED for evaluation of several months of waxing and waning bilateral lower extremity weakness with progression of symptoms causing multiple falls. Initial CT head revealed an 11 mm acute [...]

Case Presentation: A 23-year-old man with alcohol use disorder presents with abdominal swelling, lower extremity edema, jaundice, and early satiety. Physical examination revealed icteric sclera, conjunctival pallor, distended abdomen with notable ascites, and lower extremity edema. Initial labs showed macrocytic anemia at 7.5 g/dl with mean cell volume of 127.2 fL, white blood cell count [...]

Case Presentation: A 39-year-old woman presented to the emergency room with dyspnea and substernal chest pain following a dialysis session. Her history included end stage renal disease, hypertension and diabetes. Physical exam revealed a 2/6 systolic murmur at the apex. Electrocardiogram (ECG) returned with changes concerning for inferolateral ischemia prompting ST-elevation myocardial infarction (STEMI) activation.Left [...]

Case Presentation: An 80-year-old male with a history of collagenous colitis, hypertension, type 2 diabetes, microcytic anemia, exocrine pancreatic insufficiency, severe malnutrition, and vitamin D deficiency presented with weakness, chronic diarrhea, and significant weight loss (~100 lbs in one year). He had 5-7 non-bloody stools daily, unresponsive to colestipol and loperamide, accompanied by abdominal bloating [...]

Case Presentation: A 40-year-old man with history of hyperlipidemia, type 2 diabetes mellitus, and alcohol-induced liver cirrhosis complicated by portal hypertension, ascites and esophageal varices presented with three weeks of epigastric abdominal pain, nausea, and vomiting. The Physical Exam was unremarkable. Lab results showed elevated Lipase 1854 U/L, Tbili 8.1 mg/dL, Dbili 5.5 mg/dL, ALT [...]