Case Presentation: A 39 year-old female with a history of hypertriglyceridemia (HTG), IDDM2, and obesity presented to an outside hospital with severe epigastric abdominal pain and was diagnosed with recurrent hypertriglyceridemia-induced pancreatitis (HTGP). Intravenous insulin was started and she was transferred to our hospital for management. On arrival, she was tachycardic and tachypneic with a [...]

Case Presentation: Type A Lactic acidosis is commonly caused by decreased oxygen delivery and poor peripheral perfusion. Type B lactic acidosis ensues in absence of hypoxia or tissue hypoperfusion, mostly occurring in alcoholism, mitochondrial dysfunction, medications like metformin. We present an unusual case of Type B lactic acidosis induced by nebulized albuterol in the treatment [...]

Case Presentation: A 59-year-old female with a history of Asthma, COPD and tobacco use, unknown to have malignancy, presented to the emergency department complaining of dyspnea, cough and back pain. She had tachycardia, tachypnea and oxygen saturation was 91% on 2 liters oxygen. Physical exam was significant for bilateral wheezing.Initial workup showed a high white [...]

Case Presentation: The patient was a 54yo male with history of alcoholic cirrhosis, CKD, and depression who originally presented to the hospital for a fall, L orbital fracture, and also developed rhabdomyolysis. His hospitalization was complicated by an NSTEMI and he underwent cardiac catheterization with PCI of an anomalous circumflex artery and placement of an [...]

Case Presentation: Lyme disease a multisystem disease, occurring globally is caused by the spirochete borrelia burgdorferi and transmitted by the Ixodes tick.(6) The incidence of Lyme carditis (LC) is rare with reported incidences of 4%- 10% but recent studies showing 0.3% to 4% with high grade AV block is the most common presentation.(5,2) We present [...]

Case Presentation: A previously healthy 22-year-old male with a family history of Crohn’s disease presented with acute onset of lower abdominal pain and bloody diarrhea. He estimated that he had around seven episodes of loose stools with bright red blood but no mucus for two days. He did not have any fevers, emesis, recent travel [...]

Case Presentation: A 62 year old incarcerated male presented to an outside hospital for a near syncopal event. He reported increased general fatigue, dyspnea with exertion, edema of bilateral legs, weight gain of 20 pounds, and orthopnea over the prior two months without any other associated symptoms. His past medical history included diabetes mellitus type [...]

Case Presentation: A 69-year-old male with CKD Stage III and psoriatic arthritis on adalimumab (40 mg every 2 weeks) and methotrexate (20mg weekly) presents to the hospital after routine labs revealed macrocytic anemia and neutropenia. The patient was treated for right hand cellulitis 10 days ago in an urgent care setting with a dose of [...]

Case Presentation: A 72-year-old female never-smoker was admitted for progressive dyspnea, pleuritic chest pain, and non-productive cough after failing outpatient treatment for presumed community-acquired pneumonia based on chest x-ray findings. On arrival, she was afebrile, hemodynamically stable, and breathing comfortably on room air. Physical exam revealed pulmonary crackles and a clean-based ulcer on the lateral [...]

Case Presentation: A 73-year-old woman with a past medical history of hypertension and osteoarthritis presented to the emergency department with progressive right lower back pain after a mechanical fall, subacute oropharyngeal dysphagia, and diffuse proximal and distal muscle weakness. On presentation, she was afebrile with unremarkable vital signs. Her labs were significant for a WBC [...]