Case Presentation: A 40 year old woman (G4P4A0) with hypertension and hypothyroidism presented with sudden onset, severe, substernal chest pain while lifting heavy garbage bag. She was diagnosed with NSTEMI in the context of typical ischemic chest pain with trending troponins and EKG with T wave inversions in anterior leads. Transthoracic echocardiography revealed apical and [...]

Case Presentation: An 84 year old female with a past medical history significant for systemic lupus erythematous (SLE) presented to the emergency department with fatigue and dizziness. She had recently been admitted to the same hospital with acute kidney injury secondary to lupus nephritis. During that admission, she was started on high dose prednisone, a [...]

Case Presentation: A 23-year-old male college student with no PMH or significant FH presented to the ER with a 12hr history of recurrent substernal chest pain associated with diaphoresis, dyspnea, nausea and vomiting. Initial vitals were BP 129/82mmHg, HR 94 bpm, RR 18 breaths/min, SpO2 100% on RA and afebrile. No significant findings on examination. [...]

Case Presentation: A 56-year-old Caucasian female with history of mechanical aortic and mitral valves on chronic warfarin therapy, atrial fibrillation, and questionable history of SLE was admitted to the intensive care unit for emergent splenectomy following a motor vehicle accident. After initially being sent home from a regional hospital, she was diagnosed five days later [...]

Case Presentation: A 32-year-old woman with history of lupus not on steroid or immunosuppressive therapy for more than 10 years presented with headache, generalized weakness, abdominal pain, nausea, vomiting, and malaise. On exam, the patient was afebrile with tachycardia and hypotension. She was ill-appearing with a diffusely tender abdomen, mild hepatomegaly, and enlarged axillary and [...]

Case Presentation: A 51-year-old woman presented with recurrent confusion and altered mental status over the past 6 months. She reported associated hallucinations, altered sleep cycle and hyper-arousal symptoms. She was treated with lactulose and rifaximin for suspected hepatic encephalopathy with no improvement. She denied any other symptoms. Past medical history was significant for cirrhosis secondary [...]

Case Presentation: A 19 year old female presented to the student clinic with fevers up to 103 degrees F recurring daily over a period of weeks. She endorsed diffuse body aches and nausea/vomiting. Two years prior, she was diagnosed with Kikuchi disease, a benign self-limited lymphadenitis, following a lymph node biopsy in Bangladesh. Symptoms at [...]

Case Presentation: : A 34-year-old female with history of migrainous headaches presented with complains of sudden onset, throbbing type of headache radiating to the back of the ear. This was associated with sudden loss of vision in the right eye. She also mentioned night sweats and unintentional weight loss in the last couple of months. [...]

Case Presentation: A 70-year-old man with no significant history presented with lower back pain for 1 month. The pain, specifically involving the bilateral lower back which radiated down the buttocks, was sharp, intermittent, and 10/10 in severity. His pain started gradually but progressively worsened, limiting the patient’s ability to ambulate. The patient reported constipation for [...]

Case Presentation: A 24 year old Afro-Caribbean woman with no medical history presented with intermittent facial swelling of one month, several months of fatigue, anorexia and unintentional weight loss of 65 pounds. The swelling initially involved the lower face with gradual spread to bilateral peri-orbital areas. There was no urticaria, rash, dysphagia, dyspnea or visual [...]