Case Presentation: 40-year-old woman with history of pernicious anemia, fibromyalgia and depression presented with progressive fatigue and weakness with associated myalgias and bilateral hip and shoulder girdle pain. Outpatient evaluation initially attributed these symptoms to worsening depression and fibromyalgia and amitriptyline was prescribed. Unfortunately, symptoms progressed and baclofen was started with minimal relief. Over the [...]

Case Presentation: An 80-year-old man with a past medical history of chronic lymphocytic leukemia, coronary artery disease, diabetic chronic kidney disease and heart failure reduced ejection fractionwith two months of intermittent hematochezia. Since onset of symptoms, the patient had required nine transfusions. His admission exam was remarkable for jugular venous distension, trace ankle edema, a [...]

Case Presentation: A 24-year-old female with a history of ovarian cancer 4 years ago, s/p salpingo-oophorectomy and chemotherapy presents with acute onset of shortness of breath x 1 day.  She denied any fevers, chest pain, or hemoptysis. On exam, she was afebrile, normotensive but tachycardic to 125, tachypneic to 20, and hypoxic to 91% on [...]

Case Presentation: A 24 year-old male presented with rash and fever for one month. He was recently diagnosed with bipolar disorder and started on fluphenazine, lithium, and benztropine. Four weeks after starting these medications he developed a diffuse pruritic rash, intermittent fevers, confusion and lethargy. On evaluation the patient was febrile and tachycardic, with a [...]

Case Presentation: A 65-year-old male presented with sharp severe chest pain, worsened with respiratory movements. One day prior to admission, patient had catheter ablation due to persistent atrial fibrillation. He had no other medical history. Initial echocardiogram was normal and pericarditis treatment was started. Two days later, patient’s symptoms worsened: nausea and odynophagia. Repeat bedside [...]

Case Presentation: A 51-year-old woman with multiple medical co-morbidities including morbid obesity with body mass index of 84, hepatitis C cirrhosis, urinary retention requiring chronic indwelling foley catheter and bilateral non-obstructing renal calculi presented from her nursing home with altered mental status, tachycardia, hypotension, and urinalysis findings consistent with urinary tract infection. She had a [...]

Case Presentation: A 67 year-old man with history of hypertension and hyperlipidemia presented with two weeks history of slurred speech and a transient left facial numbness and twitching for one day. Three months prior he fell of his bike with consequent closed head trauma without loss of consciousness (the helmet broke as well). Head CT [...]

Case Presentation: A 23 year-old man with no prior medical history presented with witnessed syncope.  Patient was playing basketball when he suddenly collapsed, initially unresponsive, regaining consciousness after minutes.  No seizure activity was observed.  VS were BP 116/71, HR 55, RR 16, O2sat 100% RA.  ECG showed sinus bradycardia with right axis deviation.  Physical exam [...]

Case Presentation: A 59-year-old male with history of liver cirrhosis secondary to hepatitis C presented with right-sided jaw pain and swelling.  Two weeks prior he developed a sore throat and fever.  He started taking amoxicillin prescribed for him by his primary care physician and the sore throat and fever resolved.  A week later he developed [...]

Case Presentation: A 91-year-old Puerto Rican female presents with a productive cough for 3 weeks and progressively worsening shortness of breath for 1 week. Over the course of 1 year she was admitted to the hospital twice, presented to the ED 4 times, and had numerous visits with her primary care physician for the same [...]