Case Presentation: A 7-year-old male with medical history of an unrepaired moderate sized restrictive ventricular septal defect and dilated aortic root was admitted for 2-week history of fevers up to 107°F. He had dental surgery approximately 1 month prior and did not receive endocarditis prophylaxis. He was evaluated by his primary physician at the onset [...]

Case Presentation: A 17-year-old female with no past medical history was admitted to a tertiary care children’s hospital with acute onset of abdominal pain, nausea, emesis, oral ulcers, and vaginal rash. She was sexually active with the last unprotected encounter nine days prior to presentation. She endorsed dysuria but denied vaginal discharge. The patient was [...]

Case Presentation: A 15-year-old female with a history of migraines presented with headache and confusion. On the morning of presentation, the patient endorsed a migraine-like headache that was not relieved with over-the-counter medications, blue/gray discoloration of her hands, and shortness of breath. Review of systems was positive for anxiety, chest pain, and lightheadedness and negative [...]

Case Presentation: 17 year old female with history of severe persistent asthma, allergies, and chronic marijuana use presents with one month of worsening dyspnea, cough, and chest pain, after treatment for left lower lobe pneumonia and asthma exacerbation.She was afebrile, tachycardic, tachypneic, but saturating well on room air. Lung exam had diminished breath sounds at [...]

Case Presentation: An 8-year-old fully vaccinated female developed fever, abdominal pain, sore throat, and vomiting 6 days prior to admission. When seen by her pediatrician 4 days prior, she had an erythematous oropharynx and was treated with amoxicillin for streptococcus pharyngitis. The following day, she developed blood-streaked emesis and was seen in a local Emergency [...]

Case Presentation: A 3-year-old female presented with 1-day of fatigue, pallor, dyspnea and dry cough. Vital signs showed HR 152, RR 28, temp 98.8 F, BP 101/67, and oxygen saturation of 75% on room air. On exam, she was well appearing, with clear lungs and no respiratory distress despite the desaturations. Initial testing showed a [...]

Case Presentation: An 11 year old male with nonverbal autism, complex partial epilepsy, and repaired coarctation of the aorta presented with failure to bear weight, rash, and easy bruising. Family history was positive for rheumatoid arthritis. The patient’s diet was limited due to food selectivity. Physical exam was significant for bilateral hip pain and petechiae [...]

Background: CD-19 Chimeric Antigen Receptor – T (CAR-T) cell therapy is FDA approved for the treatment of primary refractory or recurrent Diffuse Large B-Cell Lymphoma (DLBCL) after two or more lines of systemic therapies have failed. The two commercially available products are Yescarta (axicabtagene ciloleucel) and Kymriah (tisagenlecleucel). In clinical trials, 54% of 111 patients [...]

Background: Preventable ED visits account for 20-50% of ED visits. (1, 2) Though student-run free clinics (SRFCs) could play an important role in decreasing unnecessary utilization, current ED utilization in SRFCs and risk factors have not been described. Methods: We conducted a cross-sectional study of patients receiving care at a student-run free clinic. We captured [...]

Background: Patient out-of-pocket costs are a critical consideration when providing care as they can represent a substantial portion of a patient’s income and when they are exceedingly high can become a barrier to care. We sought to better understand Physician interaction with and reaction to out-of-pocket costs at the trainee level. Methods: A nineteen-question survey [...]