Case Presentation: A 44 year old gentleman with a past medical history significant for Crohn’s disease presented for evaluation of painless jaundice and a pancreatic mass in the setting of significant unintentional weight loss and recent flu-like symptoms including night sweats, low-grade fever, and dizziness.  Prior to admission, the patient underwent computerized tomography of the [...]

Case Presentation: A 49-year-old male with a past medical history significant for male sexual encounters, gonorrhea, depression and prior negative HIV and syphilis screening presented to the Emergency Department sent by his PCP with abnormal lab results that included a RPR 1:32 and positive Treponema pallidum antibodies.  The patient complained of subjective fevers for two [...]

Case Presentation: A 64-year-old obese male with history of atrial fibrillation, congestive heart failure (CHF) and alcohol use presented with subacute worsening of lower extremity edema, fatigue, and exercise tolerance. Five months prior to presentation, he was admitted to an outside hospital with newly diagnosed atrial fibrillation and CHF. At that time an echocardiogram showed [...]

Case Presentation: A 63-year-old female with no PMH or FH of heart disease presented to the ER with dyspnea and pressure-like central chest pain. She reported a 3-week history of cough, sore throat and rhinorrhea. On evaluation, vital signs were T 97.8°F, BP 143/85 mmHg, HR 150/min, RR 20/min and SpO297%. Physical exam was significant [...]

Case Presentation: A 65-year-old female, Spanish speaking, Jehovah’s Witness, with a past medical history of insulin-dependent diabetes, PUD 2/2 H pylori treated but not tested for cure, and osteoarthritis who presents with hematemesis of one-day duration and abdominal pain of 5 days duration.The patient woke up vomiting blood on the morning of admission. While the [...]

Case Presentation: A 39-year-old Mexican man with a history of rheumatoid arthritis and diabetes presented with 5 days of abdominal pain. Pain was peri-umbilical without radiation. He had not taken any prescription medications for more than a year. He smoked cigarettes for more than 20 years, but denied use of alcohol or illicit drugs. He [...]

Case Presentation: A 31 year old male with cystic fibrosis presents to the ER complaining of episodic, sharp, and diffuse abdominal pain associated with nausea, vomiting, and obstipation for 3 days. On physical examination, the patient’s abdomen was distended and diffusely tender to palpation, with hypoactive bowel sounds, and no palpable masses.  CT abdomen revealed [...]

Case Presentation: 59-year-old male with history of hypertension, insulin dependent diabetes mellitus type two, alcohol abuse, and depression/anxiety presented to the Intensive Care Unit by emergency medical service after being found down by his neighbors with multiple empty alcohol bottles around him. Vital signs were significant for heart rate 115. Lab data included sodium 146, [...]

Case Presentation: 69-year-old male with history of cirrhosis from nonalcoholic steatohepatitis, coronary artery disease, hypertension, and diabetes presents to hospital for abdominal pain and weakness. Before the onset of symptoms earlier in the day, he states he was lifting heavy objects and exerting himself. On physical exam, patient was pale, with abdominal distention and diffuse [...]

Case Presentation: 54-year-old male with history of atrial fibrillation (afib) and hypertension presents for diabetic ketoacidosis (DKA), with newly diagnosed diabetes, septic shock and back pain. He reports left hip and lower back pain since experiencing a fall down the stairs 2 months ago and worsening pain in the past 2 weeks. He reports seeing a chiropractor. [...]