Background: Ensuring that hospitalized patients have a clearly documented Advance Care Plan (ACP) is important to provide them with goal-concordant care. Our institution undertook an inpatient Quality Improvement (QI) initiative to improve accessible ACP documentation. Though this work significantly improved ACP documentation rates, ACP rates for Latinx patients were significantly lower than those of the [...]

Background: The Centers for Medicare & Medicaid Services (CMS) uses a five‐star quality rating system to measure Medicare beneficiaries’ experience with their health care system. Unplanned readmission rates serve as a marker of the effectiveness and safety of its transitional care process and carry significant weight in determining a hospital’s overall rating. Our institution, an [...]

Case Presentation: A 15-year-old male with a history of depression and schizoaffective disorder began having general malaise and nausea four days prior to hospital presentation. His symptoms progressed to include difficulty walking, vomiting, and the development of tremors. He was found to have a lithium level of 3.3 as an outpatient and was admitted to [...]

Case Presentation: This is a case of a 68-year-old female with a history of a recent cryptogenic stroke and atrial fibrillation who presented for an elective TEE for patent foramen ovale (PFO) evaluation and possible closure. TEE revealed a PFO with evidence of a right-to-left shunt. After completion, the patient reported exquisite neck tenderness, severe [...]

Case Presentation: A 35-year-old woman with a history of congenital renal dysplasia complicated by end stage renal disease (ESRD) on hemodialysis, chronic macrocytic anemia, and malnutrition with folate, vitamins B12 and A deficiencies, presented with fatigue, dyspnea, and new rash. One week prior to presentation, the patient started experiencing progressive dyspnea on exertion. At her [...]

Case Presentation: We describe a case of TTP that developed subsequent to diagnosis and empiric treatment of AML. The patient was a 71 year old male with a past medical history of hypertension, hyperlipidemia, and stage III CKD who presented with a three-week history of fatigue, fevers, chills, and dyspnea. He was found to have [...]

Case Presentation: A 51-year-old female with no significant medical history presented to the hospital after a ground-level fall with severe thoracic back pain, paresthesia, paresis of both lower extremities and urinary incontinence. Exam revealed thoracic spine tenderness, bilateral diminished sensation up to two inches above the umbilicus and 1/5 bilateral lower extremity strength. Spinal MRI [...]

Case Presentation: A 69-year-old male with past medical history of bipolar disorder, schizophrenia, and substance abuse presented to the ED with suicidal and homicidal ideations, and hallucinations. He tested positive for COVID-19 at an outside hospital a week prior to presentation. He endorsed subjective fevers and productive cough with non-bloody sputum and denied dyspnea, chest [...]

Case Presentation: A previously healthy 29-year-old woman was diagnosed with end-stage renal disease of unknown etiology and initiated on daily peritoneal dialysis. Patient reported poor compliance with this treatment regimen and, five months later, presented to the emergency department with non-productive cough and pleuritic chest pain. She was found to have left upper lobe pneumonia [...]

Case Presentation: A 51-year-old male with a history of alcoholic liver cirrhosis presented with severe bilateral leg pain associated with nausea, vomiting, and diarrhea, after consuming raw oysters 36 hours prior to admission. Physical exam revealed an encephalopathic obese man with a temperature of 38.2oC, heart rate of 102 bpm, and BP of 85/50 mmHg. [...]