Case Presentation: A 32-year-old male patient presented to the emergency department with double vision, preceded by headache, and increased burning in his feet. No other neurologic symptoms were reported. Past medical history was significant for poorly controlled, labile type 1 diabetes mellitus. His home medications included gabapentin for peripheral neuropathy, long-acting and short-acting insulin regimen. [...]

Case Presentation: A previously healthy 19 year-old female presented to the emergency room with complaints of nausea, headaches, polyuria, polydipsia and anorexia for four days. She denied urinary urgency or frequency. Her exam was unremarkable except for a flat affect and slowed speech. She was found to have hyperglycemia to 401mg/dL, elevated beta hydroxybutyrate to [...]

Case Presentation: A 39-year-old previously healthy woman presented to the hospital with worsening fever, arthralgia, nausea, vomiting, and diarrhea after discovering a tick bite two weeks prior. She was diagnosed outpatient with Rocky Mountain Spotted Fever (RMSF) ten days before hospital presentation and was prescribed doxycycline, although she missed most doses due to emesis. On [...]

Case Presentation: A 48-year-old woman with invasive ductal adenocarcinoma of the breast presented with three weeks of progressive dyspnea on exertion and a non-productive cough. She was tachycardic and tachypneic but otherwise hemodynamically stable. Physical exam was only notable for labored breathing and obesity. Basic lab work was unremarkable. Arterial blood gas showed respiratory alkalosis [...]

Case Presentation: A 61-year-old man with decompensated non-alcoholic steatohepatitis cirrhosis and end-stage renal disease (ESRD) presented with sudden-onset hypotension. He described 3 days of fatigue, lethargy, and loss of appetite with a history of breeding chickens. He was afebrile, blood pressure was 70/40, and abdomen was distended without tenderness to palpation. Initial diagnostic paracentesis showed [...]

Case Presentation: A 49-year-old male with a history of warfarin non-compliance left popliteal deep vein thrombosis (DVT), was admitted for dyspnea, left arm pain and bilateral lower extremities edema. In addition to new evidence of DVTs, the patient was found with nephrotic syndrome (NS). Chest CT showed concern for bronchogenic malignancyand enlarged kidneys. He underwent [...]

Case Presentation: A 62-year-old male with a history of type 2 diabetes mellitus, incidental left adrenal adenoma (3 cm), and resistant hypertension presented to the hospital with diffuse weakness, refractory hypokalemia, and hyperglycemia. Evaluation of his adrenal adenoma about a year prior had shown low serum aldosterone levels (in the setting of lisinopril use) and [...]

Case Presentation: A 45-year-old man with alcohol use disorder, immunocompetent HIV, chronic deep vein thrombosis on direct oral anticoagulant, and untreated plaque psoriasis presented with right 2nd digit pain and fever. The patient appeared ill with heart rate of 115 and respiratory rate of 25. On exam, the right 2nd digit was warm and diffusely [...]

Case Presentation: A 68-year man presented to the hospital due to 2 weeks of acute abdominal pain with nausea, vomiting, diarrhea and the inability to tolerate his jejunostomy tube feeds, resulting in 20lbs of weight loss. Past medical history includes Stage 4 gastric adenocarcinoma, coronary artery disease, and hypertension. After diagnosis of gastric cancer 1 [...]

Case Presentation: A 75-year-old man presents with altered mental status for one day. On exam, patient was nonverbal, opening eyes spontaneously, and responsive to painful stimuli. CT head, chest x-ray, urinalysis, blood cultures, urine cultures, metabolic panel, blood counts, and toxicology screen were all not significant for acute findings.The patient has a history of stage [...]