Background: Laboratory testing is one of the highest volume medical activities in a health system. Despite their central role in driving clinical decision making, laboratory diagnostics are highly variable and expensive. The annual cost estimate in the U.S. for low value screening, testing, or procedures range from 17.2 billion to 27.9 billion dollars.1 Excessive laboratory [...]

Case Presentation: A 24-year-old Caucasian female with a family history of multiple autoimmune disorders presented with 3 weeks of bruising, petechiae, fatigue, and outside labs that revealed significant anemia and thrombocytopenia. Admission workup showed Hgb 7.6, platelets (PLT) < 3,000, and elevated MCV. Further labs showed elevated LDH, indirect bilirubinemia, haptoglobin< 10, and positive DAT [...]

Case Presentation: A 90-year-old man with chronic kidney disease and benign prostatic hyperplasia presented with a 4-month history of persistent mucous diarrhea, abdominal pain, and a few episodes of enterorrhagia. On exam, vital signs were normal except for hypotension. He was in mild acute distress but alert and oriented. He had dry mucous membranes and [...]

Case Presentation: A 45-year-old woman initially presented with sudden dizziness upon sitting up, followed by persistent holocranial pressure headaches, blurry vision, and visual distortions resembling a kaleidoscope effect. The patient has primarily received outpatient care for persistent headaches and has undergone frequent monitoring due to worsening cognitive decline for which she was referred to a [...]