Background: Our standard Hypoglycemia Protocol primarily utilizes juice to treat hypoglycemia. The system currently allows both the Hypoglycemia Protocol and a renal diet to be active simultaneously. This algorithm has no restrictions on administering orange juice to treat hypoglycemia for patients despite exclusion of orange juice for patients on a renal diet. Considering anecdotal instances [...]

Background: Kidney injury significantly reduces renal clearance, posing unique challenges for patients with type II diabetes, particularly those on insulin. This reduced clearance can lead to elevated insulin levels, increasing the risk of hypoglycemia and subsequent complications, which often extend the patient’s length of stay (LOS). Chronic kidney disease (CKD) itself is an independent risk [...]

Case Presentation: A 67-year-old man with a history of chronic back pain from a motor vehicle accident (MVA) 20 years ago presented to his primary care provider for an annual visit in December 2023. He complained of persistent back pain. Lab work was unremarkable and an x-ray showed degenerative lumbar spine changes. The patient was [...]

Case Presentation: A 71-year-old man presented with 1 week of progressive fatigue and weakness. Upon arrival, he stated that he could not get out of bed, even to use the bathroom. Notably, he had undergone an infusion of carboplatin, pemetrexed, and pembrolizumab for treatment of lung adenocarcinoma 9 days before presenting. He attributed his symptoms [...]

Case Presentation: A 35-year-old female with a history of depression, psychosis, hypertension, and type 2 diabetes presented to the emergency room for severe hypokalemia found on routine labs. She was hospitalized for an episode of psychosis a month prior with a suicide attempt and was being treated at an inpatient mental health clinic since then. [...]

Case Presentation: We present a case of new-onset heart failure in a 31-year-old African American woman in the context of metastatic RMC. The patient was presented with a shortness of breath, swelling and discomfort of left forearm. The patient’s clinical evaluation involved a chest CT scan, which showed a concerning 11.5 x 8.0 x 9.0 [...]

Case Presentation: A 25-year-old male with a past medical history of well-controlled Celiac disease presented to the hospital with fever and altered mental status after a wellness check was initiated by a family member. The patient was feeling unwell over the past week with fatigue, headache, sore throat, vomiting, and diarrhea. On presentation he was [...]

Case Presentation: An 84-year-old male with oncologic history of oligometastatic ccRCC, metastatic prostate cancer and melanoma was found to have a 16mm enhancing, pancreatic head mass on evaluation of an infrarenal abdominal aortic aneurysm on computed tomography (CT). At age 61, he underwent a left radical nephrectomy for a 5 cm, Grade II ccRCC with [...]

Case Presentation: A 71-year-old Caucasian female with history of atrial fibrillation, gastroesophageal reflux disease, chronic kidney disease stage 3a was admitted for 2-week history of nausea, vomiting, and decreased urinary output. The patient had a recent admission for atrial fibrillation with rapid ventricular rate without causative etiology identified and was discharged on amiodarone and apixaban. [...]

Case Presentation: A 38-year-old woman with suspected metastatic right breast cancer presented to the acute care hospital for a second opinion. The patient first noticed a breast lump one year ago and had been receiving homeopathic medical care without improvement. She was evaluated in a foreign country one week prior to admission and was advised [...]