Case Presentation: Electrocardiograms (ECG’s) hold a strong diagnostic value in medicine. They are of particular usefulness when that can be extended to the prognostic arena. In a few cases, it offers particularly important information in the short term. One such finding is the presence of T wave alternans.  A 56 year old female with past [...]

Case Presentation: An 18 year-old Hispanic female presented to a tertiary care center with six days of left-sided flank pain and gross hematuria. Upon further questioning, she additionally endorsed  two to three months of generalized malaise and unprovoked weight loss totaling eight pounds. She had been discharged from a nearby hospital one day prior to [...]

Case Presentation: 53-year-old postmenopausal Caucasian female presented with low-trauma, recurrent metatarsal fractures. She reports her first metatarsal fracture at age 21, and since then had at least 8 more metatarsal fractures over her lifetime. On further inquiry, she reported history of gait disturbance as a child and dental issues (spacing and loosening). Labs showed normal [...]

Case Presentation: A 75 year old Caucasian woman, previously diagnosed ET and atrial fibrillation, presented to emergency room with acute on chronic shortness of breath. Her dyspnea was earlier attributed to chronic bronchitis in the absence of evidence of any other pathology. However, this time she had bilateral coarse crackles which correlated with her chest [...]

Case Presentation:      A 30  year old African American  female with history of Systemic Lupus Erythematosus  and secondary Lupus nephritis presented with painful erythematous blisters on her hands and feet along with dysphagia and oral ulcers.  It was  discovered that 2 weeks  prior she was started on mycophenolate mofetil for treatment of her lupus [...]

Case Presentation: A 77-year-old African-American male with Adult-onset Still’s disease (AOSD) was admitted at the hospital for severe thrombocytopenia. The patient had been diagnosed with AOSD four years before this hospital admission. His AOSD was well-controlled with anakinra, an interleukin-1 receptor antagonist, and low-dose prednisone. On admission, the patient did not have any neurological manifestation. [...]

Case Presentation: A 70-year-old gentleman with past medical history significant for chronic hypoxic and hypercapneic respiratory failure from chronic obstructive pulmonary disease (FEV1 of 0.76 liters, 22% of predicted), hyperlipidemia, and hypertension presented with worsening exertional shortness of breath of four days duration. He also had dry cough. He denied fever, chills, chest pain, paroxysmal nocturnal dyspnea or [...]

Case Presentation: A 55 year old male with past medical history significant for congestive heart failure, severe persistent asthma and eosinophilic pneumonia on chronic prednisone and status post bronchial thermoplasty presented with fever, cough, shortness of breath and chest pain of 2 weeks and hemoptysis of 3 days duration. He also had two recent hospitalizations [...]

Case Presentation: A 25-year-old female presented with a 2-day history of right-sided abdominal pain, nausea and vomiting. She had multiple emergency department visits for lower back pain for the last 3 years. CT scan of abdomen showed right advanced chronic hydronephrosis secondary to ureteropelvic junction (UPJ) stenosis. Labs revealed normal renal functions. UPJ stenosis was [...]

Case Presentation: An 80 y/o Hispanic man with past medical history significant for COPD, ascending aortic aneurysm s/p graft repair 10/06, and recent biventricular pacemaker implantation 4/16 due to third-degree heart block presented with dyspnea, productive cough, orthopnea and fever to 103 F in 5/16. Physical examination revealed III/VI diastolic murmur, bilateral pulmonary rales, peripheral [...]