Case Presentation: A 47-year-old female with a history of hypertension was admitted with worsening dyspnea, leg swelling, and a blood pressure of 219/147. She was nonadherent to home BP meds due to cost. Exam showed signs of fluid overload, including pitting edema and jugular venous distention. Labs revealed elevated serum creatinine (1.38 mg/dL), calcium (11.0 [...]

Case Presentation: A 72-year-old male presented to the emergency room for macrocytic anemia and a creatinine of 9.72 mg/dL on outpatient lab work. Past medical history was notable for paroxysmal supraventricular tachycardia, gastroesophageal reflux disease and heart failure with reduced ejection fraction. On admission, he complained of six months of fatigue with constipation, 60 lbs [...]

Case Presentation: This is a 37-year-old male presented to ED with bilateral leg numbness and incontinence. An MRI was done that revealed herniation of nucleus pulposus of lumbar intervertebral disc with sciatica and he was taken to the OR for an emergent Full L4 laminectomy, bilateral L4-5 microdiscectomies, bilateral foraminotomies of the S1 nerve roots, [...]

Case Presentation: A 66-year-old male with a past medical history of hypertension, atrial fibrillation, and diabetes initially presented to the hospital with shortness of breath, fatigue, and several episodes of bloody stool after two weeks of intermittent bloody stool at home. He reported that he had seen his PCP who had initiated a workup but [...]

Case Presentation: Many patients are being treated with biologic therapies for autoimmune diseases in the outpatient setting. It is critical for the hospitalist to recognize these patients as immunosuppressed and generate a broad differential when they are admitted to the hospital. The patient in this case was a 35-year-old male with a past medical history [...]

Case Presentation: A 68-year-old male with hypertension and benign prostatic hyperplasia presented with progressive abdominal distension and pain. He denied fever, weight loss, gastrointestinal bleeding, or any history of gastrointestinal diseases. Physical examination revealed a distended, non-tender abdomen with normal bowel sounds.Laboratory tests showed elevated lactate dehydrogenase (LDH) at 750 U/L, hyperuricemia at 9.0 mg/dL, [...]

Case Presentation: A 71-year-old male from Vietnam with HTN and TIIDM presented to an outside hospital with several weeks of fatigue, lower extremity bruising, and an unintentional weight loss of 20lbs. On admission to Stanford, he also endorsed right lower extremity numbness and weakness with right foot dorsiflexion. His exam was notable for scattered ecchymosis [...]

Case Presentation: A 32-year-old man with a past medical history of hypertension and stage IV chronic kidney disease (CKD) was brought to the hospital by emergency medical services after he was found unresponsive. His initial blood pressure was 266/166 mmHg in the ambulance.Upon physical examination, patient remained unresponsive, with occasional gaze deviation to the right [...]

Case Presentation: A 27-year-old male with end stage renal disease from focal segmental glomerulosclerosis with living donor transplant and progression to chronic kidney disease presented with 2 weeks of diarrhea, proctalgia, and hematochezia. On presentation he was afebrile and hemodynamically stable. Rectal exam showed significant tenderness, no hemorrhoids or fluctuance, and mucous-like drainage. Labs showed [...]

Case Presentation: A 33-year-old man with end-stage renal disease status post renal transplant was readmitted to the hospital with recurrent acute kidney injury (AKI).During his first admission, he reported a few weeks of nonproductive cough, dyspnea, congestion, chills, and recent nausea with vomiting. He was afebrile with normal vital signs and normal SpO2. Respiratory panel [...]