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Meetings Archive For Hospital Medicine 2011, May 10-13, Dallas, Texas...

Abstract Number: 354
Gallstone Pancreatitis in a Previously Healthy 22‐Year Old Man: What Does Not Fit?
Hospital Medicine 2011, May 10-13, Dallas, Texas.
Case Presentation: A 22‐year old previously healthy man developed acute‐onset right upper quadrant pain, vomiting, and jaundice. He consumed 4–6 alcoholic drinks occasionally and denied diarrhea, bloody stools, or fevers. Medical history was notable for a possible diagnosis of irritable bowel syndrome without previous workup. On examination, he was tachycardic and visibly jaundiced and had [...]
Abstract Number: 355
Recurrent Syncope: A Plethora of Causes
Hospital Medicine 2011, May 10-13, Dallas, Texas.
Case Presentation: A 69‐year old man with a history of congestive heart failure was admitted for recurrent syncope. He initially presented with 4 months of progressive dyspnea on exertion and facial swelling. Subsequently, he developed at least 20 episodes of syncope precipitated by leaning forward or rapid positional changes. Tilt table testing and orthostatic vital [...]
Abstract Number: 356
Severe Thrombocytopenia Secondary to Phenytoin Toxicity
Hospital Medicine 2011, May 10-13, Dallas, Texas.
Case Presentation: A 48‐year‐old white woman was brought in by her husband for dizziness, unsteady gait, altered mental status, and 1 episode of fall. Symptoms started about 1 week earlier following an upper respiratory infection treated with azithromycin. She had been on phenytoin for a seizure disorder for 4 years. She was on 300 mg twice [...]
Abstract Number: 357
Attacked from All Sides: A Confounding Case of Renal Failure
Hospital Medicine 2011, May 10-13, Dallas, Texas.
Case Presentation: A 63‐year‐old man with chronic stag‐horn nephrolithiasis and chronic kidney disease presented with generalized arthralgias of 3 weeks’ duration, worse in the morning. In the days prior to presentation, he noticed pink urine and dull right flank pain. A staghorn calculus in the right kidney and nephrolithiasis in both ureters were diagnosed months [...]
Abstract Number: 358
A Strange Habit Causing Hacek Aicd Lead Infection and Endocarditis
Hospital Medicine 2011, May 10-13, Dallas, Texas.
Case Presentation: A 20‐year‐old man with a history of congenital long QT syndrome status post–automatic implantable cardiac defibrillator (AICD), intravenous drug abuse, and hepatitis C presented with 1 week of low‐grade fever and myalgia. Last drug use was 1 day ago. The patient had no cough, rash, diarrhea, or dysuria. Vital signs were: temperature 37.9°C, [...]
Abstract Number: 359
Fishing for a Diagnosis
Hospital Medicine 2011, May 10-13, Dallas, Texas.
Case Presentation: A 48‐year‐old Chinese man reported a 1‐day history of paresthesias, shortness of breath, anxiety, and profound total‐body weakness. The evening prior to presentation he had prepared some dried blowfish that he had brought from China by rehydrating it in broth and cooking it thoroughly. Shortly after eating, he developed circumoral numbness and tingling. [...]
Abstract Number: 360
Goltz Syndrome: Rare Syndrome with Multiorgan System Involvement
Hospital Medicine 2011, May 10-13, Dallas, Texas.
Case Presentation: A baby girl was born about 6 months ago after a cesarean section at 36 weeks with APGARs of 8 and 8 and body weight of 2030 g and received routine resuscitation. Mother is a 33‐year‐old Asian Indian G3P2 and had normal PNL. The mother's pregnancy was complicated by gestational diabetes, neurofibromatosis, and intrau‐terine [...]
Abstract Number: 362
Rare Case of Breast Cancer Metastasis to Colon
Hospital Medicine 2011, May 10-13, Dallas, Texas.
Case Presentation: A 59‐year‐old white woman with a history of breast cancer presented with a 3‐day history of sharp, crampy right lower abdominal pain, radiating to the left lower quadrant and associated with nonbloody diarrhea and vomiting. She was diagnosed with ductal carcinoma in situ in her right breast and had a right mastectomy in [...]
Abstract Number: 363
Intussusception: A Rare Complication of Hereditary Angioedema
Hospital Medicine 2011, May 10-13, Dallas, Texas.
Case Presentation: This is a 16‐year‐old African American male with a history of hereditary angioedema of unknown type, diagnosed at age 12, who presented with abdominal pain. He reported a 1‐week history of intermittent non‐bloody diarrhea with abdominal pain that was consistent with his normal flares of angioedema. However, on the day of presentation, he [...]
Abstract Number: 364
A Case of Gastrointestinal Bleed with a Congenital Twist
Hospital Medicine 2011, May 10-13, Dallas, Texas.
Case Presentation: A 48‐year‐old woman presented with 2 episodes of bright red blood per rectum. Medical history included diverticular disease responsible for a previous episode of gastrointestinal bleed and congenital adrenal hyperplasia from 21‐hydroxylase deficiency. On exam, the patient had predominant masculine features, male pattern frontal baldness, and hemoglobin of 15.6. After being admitted, her [...]