Case Presentation: A 20 year old male with past medical history of Type 1 Diabetes and Hypothyroidism presented to our hospital with severe hypocalcemia. His calcium was 5.8 mg/dl (normal range 8.6-10.3 mg/dl). His ionized calcium was 0.76 mmol/L (normal range 1.15-1.33 mmol/L). He had been complaining of generalized weakness for couple of weeks. Both [...]

Case Presentation: A 46-year-old male with a history of type II diabetes mellitus on metformin presented with five days of severe, post-prandial epigastric pain with inability to tolerate meals. Labs on admission were notable for mild hyperglycemia with finger stick blood glucose between 100 and 200 mmol/L with an anion gap of 21, pH 7.3, [...]

Case Presentation: A 63 year-old man with diabetes mellitus, hypertension, and GERD presented from an outside hospital with bilateral upper extremity paralysis, paresthesias, and neck pain which started minutes after sneezing. Vital signs were stable and neurologic examination was remarkable for bilateral upper extremity strength of 0/5 with absent reflexes and reduced sensation to pinprick. [...]

Case Presentation: A 40 year-old man presented to the hospital with a six-hour history of worsening palpitations accompanied by diaphoresis and non-radiating, retrosternal chest pain. He had been diagnosed with pre-excitation on ECG three years prior and reported a longtime history of recurrent palpitations. At the time of his diagnosis he declined any further studies. [...]

Case Presentation: A 46-year-old, previously healthy woman of Korean descent initially developed heartburn associated with thirst and frequent urination. Two months later, she presented to the Emergency Department with epigastric pain and persistent thirst. She appeared euvolemic, and her initial workup was notable for a serum sodium (SNa) of 144 mmol/L and urine specific gravity [...]

Case Presentation: A 19-year-old man with a history of Chlamydia infection presented with lower extremity swelling, rash, arthralgia and fever for 6 days. He initially noticed pain and swelling localized to the left anterior shin which then spread to the left hip and left shoulder. He was sexually active with multiple female partners with inconsistent [...]

Case Presentation: A twenty-two-year-old male with unknown history was brought in with altered mental status (AMS). On exam he was lying in bed, clutching a taco sauce packet mid-air as if perpetually about to pour; he remained immobile for 10 minutes, exhibited waxy flexibility, and did not respond to questions or commands. Bush-Francis Catatonia score [...]

Case Presentation: A 29 year old Hispanic male with no significant past medical history presented to the Emergency Department with new onset jaundice. He also endorsed a constellation of symptoms for several months including weight loss, progressive fatigue, frequent headaches, decreased appetite, daily nausea with occasional emesis, and dark urine. He was not taking any [...]

Case Presentation: A 91 year-old female with history of atrial fibrillation on coumadin, hypertension, prior stroke, myeloproliferative disease, polycythemia vera and recently diagnosed macular degeneration presented with complaints of visual hallucinations for two weeks. She was in her usual state of health when she developed sudden onset of vivid visual hallucinations including people coming in [...]

Case Presentation: A 74-year-old female missionary without any past medical history was found unresponsive on the floor and brought to the emergency room. On initial physical exam she was encephalopathic but without any focal neurological deficits and an otherwise normal physical exam. Laboratory results including toxicology were all normal. CT scan of the head showed [...]