Case Presentation: A 49-year-old man with known history of class III obesity (body mass index 43), hypertension, hyperlipidemia, and insulin dependent diabetes presented to the emergency department with bilateral lower extremity swelling and dyspnea on exertion of two weeks duration. Pertinent vitals included blood pressure 161/74 mmHg, heart rate 99 beats per minute, and saturation [...]

Case Presentation: A 76-year-old man with mantle cell lymphoma status post chemotherapy 1 week prior presented to an outside emergency department with generalized weakness. Initial laboratory workup revealed hemoglobin of 8.8 g/dL, platelet count of 3 × 109/L, creatinine 5.55 mg/dL and bicarbonate 7 mmol/L (Table 1). Rectal exam showed brown stool, however fecal occult [...]

Background: The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patient perspectives of hospital care. HCAPS scoring is tied not only to hospital compensation, but also is an important indicator of and reflection of interactions with patients. Specifically at Rhode Island Hospital, the goal [...]

Case Presentation: A 30-year old woman with antiphospholipid antibody syndrome secondary to lupus with extensive arterial and venous thrombotic history presented to the emergency department with left lower extremity pain, coolness, and skin blanching for seven days. She had stopped taking her chronic anticoagulation medication two months prior to admission when she ran out of [...]

Case Presentation: An 86-year-old woman with a history of COVID-19 and MRSA pneumonia six months prior to presentation and COPD, presented to a local emergency room for abdominal pain related to persistent cough. Other pertinent history included ovarian cancer cured 20 years ago and exposure to tuberculosis when the patient was younger. Computed tomography (CT) [...]

Case Presentation: Our patient is a 62 year-old gentleman with PMH significant for HTN, moderate-severe bilateral RAS and stage IIIa CKD who was transferred to our hospital for AKI requiring dialysis. 1 month prior to presentation, spironolactone was added to his antihypertensive medications of amlodipine, carvedilol, azilsartan and furosemide. He was in his usual state [...]

Case Presentation: We present a case of 71 year old male with a history of advanced non-small cell lung cancer with metastasis to the brain, recurrent deep venous thrombosis on anticoagulation, and prostatomegaly who was initially admitted for dyspnea and subsequently diagnosed with community acquired pneumonia. His chest x-ray on admission also showed heavy burden [...]

Background: Academic hospital medicine (HM) faculty typically follow clinician educator tracks with academic hospitalists seeing education as their primary motivation for joining academic programs. According to the 2020 State of Hospital Medicine survey, shifts and clinical work hours for academic HM faculty expectations are similar to community practice (ref). Many academic HM faculty are on [...]

Case Presentation: A 34 year old male with a medical history of polysubstance abuse and hypothyroidism presented from subacute rehab after a combined thoracolumbar and sacral fixation surgery with worsening generalized weakness. The patient described deconditioning with increased difficulty standing despite 3-4 hours of daily physical therapy. Other acute symptoms included insomnia and mood swings. [...]

Background: Point-of-care ultrasound (POCUS) training was recently endorsed by the Alliance for Academic Internal Medicine (1) and the demand for training is increasing among internal medicine (IM) residency programs (2). Longitudinal POCUS training increases knowledge and skill retention compared to stand-alone workshops (3,4), but few programs currently provide longitudinal training due to institutional barriers, such [...]