Background: Routine transfusion of platelets and Fresh Frozen Plasma (FFP) prior to paracentesis is among the “things we do for no reason”, as recommended against by the American Association of Liver Disease and American Gastroenterology Association in patients with platelets over 20,000. We hypothesize that a Medicine Procedure Service (MPS), which has adopted this recommendation [...]

Case Presentation: A 46-year-old female with a medical history of type 2 diabetes, asthma, obesity, and anxiety presented to the emergency department with a five-day history of fever, myalgias, and headache. Additionally, she experienced intermittent episodes of epistaxis and gingival bleeding while brushing her teeth for the past week. She had recently returned from a [...]

Case Presentation: This case highlights a 31-year-old female who presented with severe post-prandial abdominal pain and night sweats who was identified to have marked thrombocytosis (2.5million) with only a mild leukocytosis(20K). The patient was admitted to the hospital for urgent evaluation given the risk of untreated extreme thrombocytosis. A bone marrow biopsy was conducted which [...]

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: A 75-year-old male with a history of gastrointestinal bleeding (GIB) due to angiodysplasia, aortic stenosis (AS) status post TAVR, moderate-severe mitral regurgitation (MR), CKD, GERD, and atrial fibrillation not on anticoagulation presented due to lightheadedness for 1 day when standing up, and fatigue for a few weeks. He also reported dark brown stools [...]