Case Presentation: A 60 year old female was admitted for rapid cognitive and functional decline over 6 weeks. Three months prior, she ceased working as an OR nurse due to depression and emotional outbursts and was being treated by an outpatient psychiatrist for depression. On presentation she was aphasic, echolalic and apraxic with notable outstretched [...]

Case Presentation: A 51-year-old African female with 7-year untreated HIV infection presented with sudden-onset acute psychosis. She was agitated and reported auditory hallucinations upon arrival. On exam, she was hemodynamically stable but appeared drowsy, intermittently following one-step commands. She did not have meningismus or focal neurological deficits. Physcial exam of other systems was unremarkable.CBC and [...]

Case Presentation: A 61-year-old African American female with a history of diabetes mellitus presented with right lower quadrant abdominal pain and melena for 1 week. Her stool was guaiac-positive. CBC with differential and CMP revealed severe normocytic anemia (MCV 88 fL) with a hemoglobin of 5.8 g/dL, leukocytosis (17 × 109/L), thrombocytopenia (118 × 109/L), [...]

Case Presentation: We present a case of a 62 year old woman with past medical history of HTN, CAD, bipolar disorder, osteoporosis and vertebral compression fractures, who presented to the ER 8 days after T6-T10 vertebroplasties, with pleuritic interscapular pain radiating toward the sternum. She had no dyspnea, palpitations, cough, hemoptysis. Had no tachycardia or [...]

Case Presentation: A 40 year old man was brought in by ambulance after having a 30 second tonic-clonic seizure witnessed by his mother. He was intubated on route to the hospital for airway protection. On arrival he was afebrile and hemodynamically stable. Neurological exam was notable for GCS of 8. Pupils were mildly anisocoric and [...]

Case Presentation: A 66-year-old female with a history of primary hypothyroidism presented to the emergency department with an episode of vertigo. The patient reported a persistent spinning sensation, nausea, vomiting, and tinnitus of the left ear without hearing loss for over 10 hours. Review of systems revealed abnormal gait and findings consistent with hypothyroidism (cold [...]

Case Presentation: A 64-year-old woman with a history of heart failure (HF) and end stage renal disease on dialysis presented with three days of abdominal pain. She was lethargic, hypothermic to 34.5 C, with jugular venous pulsations (JVP) to the earlobe, a systolic murmur at the left sternal border, and right upper quadrant tenderness. Laboratory [...]

Case Presentation: An 84-year-old man from China with a history of remote gastric cancer with prior subtotal gastrectomy, chronic hepatitis B virus infection on antivirals (without cirrhosis, normal liver function tests) was brought to the hospital after his family found him to be obtunded. At baseline he was independent in all iADLs. Physical exam showed [...]

Case Presentation: A 54-year-old man with metastatic melanoma presented to the hospital in acute renal failure. Nine months prior, he was diagnosed with metastatic melanoma and offered immunotherapy. He declined in favor of naturopathic treatment, including high-dose intravenous vitamin C. At his naturopathic clinic, he was found to be hyperkalemic and was referred to our [...]

Case Presentation: A 75 year-old male with past medical history of aplastic anemia requiring immunosuppression and pRBC and platelet transfusions presented to the infusion center with hypotension. He was found unresponsive with BP of 59/36 prior to receiving blood products, and was transported to the ED after receiving 1L of normal saline. On ED evaluation, [...]