Case Presentation: 39-year-old African American male presented with dyspnea and hematuria for one week. His past medical history includes stage 3 CKD and hypertension. In the emergency room he was found to be severely hypertensive with systolic blood pressures hovering around 240 mmHg. Initial laboratory tests revealed significantly elevated creatinine level from baseline and new-onset […]

Case Presentation: A 56-year-old woman with a history of Parkinson’s disease and seizures presented with a month of dyspnea and associated easy bruising. She had previously presented to the emergency room two weeks before her current presentation with swelling of her right lower extremity and bruising. Workup at this time included a lower extremity doppler […]

Case Presentation: A 32 year old male presented to the emergency department unresponsive. Three months prior he had developed urinary incontinence, cognitive impairments, paresthesias in his extremities and weakness requiring crutches. His symptoms progressed leaving him bed bound weeks prior to arrival. EMS was contacted when he became unresponsive to verbal-noxious stimuli and exhibited difficulty […]

Case Presentation: A 38 year old male with a history of anxiety and hypothyroidism who received the second dose of SARS-COV2 Pfizer-Biontech vaccination 17 days prior, presented with 4 days of severe gingival bleeding after dental cleaning, epistaxis and a petechial rash of his extremities and was found to have new onset severe thrombocytopenia of […]

Case Presentation: A 40 year-old female presented to the Emergency Department with several months of fatigue followed by acute fever and confusion. She denied weight loss, swollen glands, cough, rash, arthralgias, or myalgias. No drug or alcohol use. She was febrile to 102.5F. The remainder of the vital signs were normal, and the neuro exam […]

Case Presentation: A 57-year-old male with multiple medical conditions presented to the Emergency Room (ER) for evaluation of worsening skin rash and bleeding gums. The patient was discharged from the hospital 3 days ago and treated for an infected left prosthetic knee joint, he initially received empiric antibiotics Vancomycin and Piperacillin-Tazobactam, Cultures from tissue sample […]

Case Presentation: A 73-year-old male with a history of heart failure with preserved ejection fraction presented with one month of dizziness, weakness, dyspnea on exertion, and a 25-pound weight loss due to loss of appetite. On the day of admission, he had three brief episodes of syncope upon standing. His initial blood pressure was 64mmHg/40mmHg, […]

Background: Overtreatment or low value care, including overutilization of laboratory testing, has an estimated annual cost of waste of $75.7 to 101.2 billion annually. Providing performance feedback to hospitalists has been shown to be an effective way to encourage the practice of quality improvement focused medicine. There remains limited data regarding implementation of performance feedback […]