Inpatient Intermittent Confusion and Hypoxia – Thinking out of the Box but From the Bottle Case Presentation: A 62-year old Caucasian female, a Psychiatrist, was brought by her friend for multiple falls and heavy alcohol intake for two weeks. Vital signs were within normal range and physical examination was pertinent for mild drowsiness, hands tremor […]

Case Presentation: A 33-year-old patient with a history of ST-elevation myocardial infarction (STEMI) requiring 2 cardiac stents at the age of 30, presented with intermittent substernal chest pressure.  He denied a previous history of nicotine, alcohol, or recreational drug use, and related having an uncle with premature coronary arterial disease (CAD). His physical exam was […]

Case Presentation: A 19-year-old male with a past medical history of malaria and recent immigration to the U.S. from Somalia presented with a witnessed episode of tonic-clonic seizure. He had no history of seizure disorder, recent trauma, new medications, alcohol use, fevers or chills. He was afebrile with stable vital signs. Physical exam including neurological […]

Case Presentation: A 27-year-old man with a past medical history of ulcerative colitis (UC) presented to the hospital with pleuritic chest pain. It had been ongoing for 6 days with no alleviating or aggravating factors.  He also endorsed shortness of breath, and night sweats with no cough, fevers, chills, hemoptysis or any other symptoms. Regarding […]

Case Presentation: A 76-year-old female with a history of chronic sinusitis presented with fever and cough. Physical exam was remarkable for temperature of 102° F and diminished breath sounds in the left base. WBC was 29,400/uL and chest radiograph demonstrated a left lower lobe infiltrate with an associated pleural effusion. Chest CAT disclosed a left […]

Case Presentation: A 43-year old man presented with the acute onset of paralysis.  The patient had helped a sibling move heavy furniture throughout the day prior to admission.  He awoke from sleep that evening unable to move his extremities.  Ambulance personnel were required to transport the patient to the emergency department. The patient had experienced […]

Case Presentation: A 52-year-old woman presented with the subacute onset of exertional dyspnea and non-productive cough.  The patient admitted to smoking 10 cigarettes daily, and described the regular use of inhaled (smoked) methamphetamine. Physical exam was remarkable for rales that were most prominent in the right upper lobe and left lower lobe distributions. Room air […]

Case Presentation: A 50-year-old white female presented with the acute onset of right lower quadrant abdominal pain.   The patient’s temperature was 37.7° Celsius.  Physical examination was remarkable for voluntary guarding and rebound tenderness, which was most pronounced in the right lower quadrant.  White blood count was 7.0 k/uL.  CAT of the abdomen revealed an […]

Case Presentation: A 46 year-old gentleman presents with an acute worsening of his chronic low back pain with radiation and paresthesias down his left leg. On admission, he was febrile, tachycardiac and uncomfortable appearing. He has point tenderness of lumbar spine, normal rectal tone, 2+  patellar, Achilles reflexes and 5/5 strength in bilateral upper and […]

Case Presentation: A 55 yo African American Male with DMII, HTN, CKD, Hyperlipidemia who initially presented with worsening right leg swelling and diagnosed with an unprovoked right femoral vein non-occlusive Deep Venous Thrombosis (DVT) and occlusive thrombus of the right popliteal vein.  The patient underwent tissue plasminogen activator (TPA) administration and mechanical thrombectomy.  He was […]