Case Presentation: A 58–year–old female presented with severe respiratory distress, diaphoresis, hypertension and tachycardia. Vital signs: BP 215/106, HR 139, RR 38, SaO2 48% on room air. She was intubated due to hypoxia. Her medical history was unobtainable. A large neck mass and a BNP value of 950 were noted. Initial differential diagnoses included congestive [...]

Case Presentation: A 15–year–old primigravida with no prenatal care at 32 weeks of gestation presented with preterm contractions, abdominal pain, elevated BP and headache. An elevated sodium of 153 mEq/L was initially believed to be the result of dehydration. After IV hydration with normal saline serum sodium continued to rise and was 160 mEq/L in [...]

Case Presentation: A 41–year–old Caucasian male presented to the physician’s office with 1–week history of dysphasia along with transient left posterior jaw pain and chewing difficulty. He also felt that the food clogged on his left inner cheek during every meal. Symptoms were sudden in onset and were progressive. He did not have any trauma [...]

Case Presentation: A 52–year–old man with a history of obesity suffered a syncopal event immediately after arising from a seated position. Shortly thereafter, he developed epigastric pain, nausea and vomiting. Initial evaluation revealed orthostatic hypotension, an atraumatic head and neck, epigastric tenderness, leukocytosis, elevated lipase, and mildly elevated LFTs. ECG was normal and troponins were [...]

Case Presentation: A 67 year–old previously healthy woman with HIV (CD4 count 1233/mm3) was admitted for 1 month of progressive odynophagia and dysphagia that began with solids and progressed to liquids. She reported food “getting stuck.” These symptoms were accompanied by recurrent emesis, anorexia, and an unintentional weight loss of 14 kg. Outpatient treatment for [...]

Case Presentation: #1:69–year–old female Chinese immigrant with rheumatoid arthritis on prednisone and methotrexate presented with weakness, abdominal discomfort, cough, fever and chills. She developed sepsis with bilateral lung opacities. Endoscopic biopsy revealed Strongyloides stercoralis. #2:72–year–old male Cuban immigrant with emphysema, lumbosacral plexopathy, and recent exposure to steroids was admitted with increasing dyspnea. He developed sepsis [...]

Case Presentation: Mrs. AS is a 76–year–old female with PMH of CHF, PVOD, T2DM, atrial fibrillation, osteomyelitis, and CKD who was admitted with recurrence of intermittent mental status changes. She was functioning at her normal level, interactive, and taking care of her ADLs until August 2011 when she had the subacute onset of altered mental [...]

Case Presentation: Ms. MM is a 78–year–old female former smoker with history of MAI, OSA, HTN, and anxiety admitted with hypercalcemia and FTT. Primary complaints were progressive weakness, malaise, weight loss, and decreased appetite. Exam was notable for dysarthric speech, dysmetria, and ataxic gait. Three months PTA, she had visited the ED due to progressive [...]

Case Presentation: A 50–year–old Asian woman presented with 4 days of abdominal discomfort and progressive distention. She had no significant past medical history and did not consume alcohol. Her physical examination was remarkable for normal vital signs and a distended, non–tender abdomen with a fluid wave but without hepatosplenomegaly. Complete blood count and liver tests [...]

Case Presentation: A 19–year–old woman with a history of migraines, depression and a bony cyst in her jaw presented with abdominal pain. Three days prior, she acutely developed sharp, non–radiating epigastric pain which was worse with inspiration. She denied nausea, vomiting, diarrhea, appetite changes, or fevers. She was diagnosed with gastritis and was given ranitidine. [...]