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Abstract Number: 442
SHM Converge 2023
Case Presentation: A 49-year-old male presented for evaluation of an umbilical hernia. Past medical history was remarkable for alcohol misuse; the patient had ceased all alcohol consumption three years earlier. Physical exam revealed a protuberant, non-tender abdomen with a 4×4 cm reducible umbilical hernia. Pre-operative laboratory exam was remarkable for serum sodium of 137 mmol/L, […]
Abstract Number: 443
SHM Converge 2023
Case Presentation: A 74-year-old female with a history of restless leg syndrome, hypertension, GERD, presented with worsening fatigue, shortness of breath, and anasarca over the last 6 months. Labs revealed anemia (hemoglobin, 8.0 g/dL), thrombocytopenia (platelet count, 46K/μL), reticulocyte count 11.4%, undetectable serum haptoglobin, serum LDH >2700 U/L, ferritin 1223 ng/mL, negative direct Coomb’s test, […]
Abstract Number: 444
SHM Converge 2023
Case Presentation: A 73-year-old man with a past medical history of pancreatic adenosquamous carcinoma, biventricular heart failure with reduced ejection fraction (30-35%), and paroxysmal atrial fibrillation presented to the hospital with a 2-day history of bilateral lower extremity edema and 5-pound weight gain. Physical exam was notable for tachycardia, jugular venous distension, scleral icterus, and […]
Abstract Number: 445
SHM Converge 2023
Case Presentation: A 78-year-old female with a history of CAD, hypertension, and asthma presented to the ED with fatigue, abdominal pain, diarrhea, and decreased urine output for three days. She recently returned from Southern France where she had overexerted herself in the heat. She was ill-appearing. Vital signs and exam were normal. Significant labs/imaging: Na […]
Abstract Number: 447
SHM Converge 2023
Case Presentation: A 69-year-old male with history of iron deficiency anemia, recurrent venous thromboembolism on apixaban, splenomegaly, ulcerative colitis who presented to emergency department due to exertional shortness of breath. 6 weeks prior to admission, the dose of azathioprine was increased from 50mg daily to 100mg daily due to suboptimal 6-thioguanine nucleotide (6-TGN) level. 1 […]
Abstract Number: 448
SHM Converge 2023
Case Presentation: A 50-year-old African American female with a history of mixed connective tissue disorder with positive ANA titer, speckled pattern 1:1280, and spindle apparatus pattern 1:640, presented with worsening dyspnea, numbness, and weakness of both lower extremities. Two days prior she received the first dose of COVID-19 mRNA vaccine and later developed nausea, vomiting, diarrhea, and anorexia. In the emergency department, patient was found to have an elevated blood pressure of […]
Abstract Number: 449
SHM Converge 2023
Case Presentation: A 64-year-old male with past medical history of coronary artery disease, hypertension and weight loss of 20 pounds within 4 months presented to the hospital after he had a seizure-like activity of his upper body lasting around 10 minutes accompanied by altered mentation. Upon arrival to the emergency department, his symptoms had resolved. […]
Abstract Number: 450
SHM Converge 2023
Case Presentation: 74 year old female with past medical history of end stage renal disease on hemodialysis, hypothyroidism and atrial fibrillation on anticoagulation therapy with Apixaban presented to emergency department (ED) after an episode of near-syncope following her dialysis session. In the ED she was hypotensive and tachycardic. Electrocardiogram findings showed Atrial fibrillation(AF) with rapid […]
Abstract Number: 451
SHM Converge 2023
Case Presentation: A 57-year-old male with a history of renal transplant currently on immunosuppressive medication presents to the hospital with fevers and general malaise. Laboratory findings were significant for hypercalcemia (15.6 mg/dL) with suppressed parathyroid hormone (PTH) levels. Infectious investigation including urinalysis, chest x-ray, commuted tomography (CT) of the chest, abdomen, and pelvis, blood cultures, […]
Abstract Number: 452
SHM Converge 2023
Case Presentation: A 61-year-old male with hypertension, hyperlipidemia, and GERD presented to the ED with intermittent palpitations associated with exertional shortness of breath and near-syncopal episodes since several months. On presentation, he was in sustained Ventricular Tachycardia storm and required defibrillation 5 times despite starting on Lidocaine and Amiodarone infusions along with bolus doses of […]