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Abstract Number: 454
Hospital Medicine 2020, Virtual Competition
Background: Although the vast majority of adult patients in the United States prefer to die at home, most patients die in acute care settings. Barriers include advanced care planning, communication between inpatient and outpatient providers, and delivery of medical equipment. In 2018, our General Medicine Service Line ranked 73rd out of 98 Academic Medical Centers […]
Abstract Number: 460
Hospital Medicine 2020, Virtual Competition
Background: Hospitalization provides an opportunity to provide patients who use tobacco with evidence-based treatment for cessation, including nicotine replacement therapy, motivational interviewing, and pharmacotherapy. However, this benefit is often lost without appropriate transitions in care to outpatient cessation resources. We have found that inpatient tobacco cessation interventions at our 600-bed urban academic medical center do […]
Abstract Number: 517
Hospital Medicine 2020, Virtual Competition
Case Presentation: A 74-year-old female, with no significant past medical or travel history, developed sepsis 2 days after undergoing debulking surgery for stage IIIc ovarian carcinoma. Blood cultures were positive for gram-negative bacilli and the organisms identified as Enterobacter spp. with blaIMP MBL (Verigene). Antimicrobial susceptibility testing demonstrated high-level resistance to all penicillins, ureidopenicillins, cephalosporins, […]
Abstract Number: 557
Hospital Medicine 2020, Virtual Competition
Case Presentation: A 73-year-old female with PMH of iron deficiency anemia, laparoscopic cholecystectomy, and hernia repair had received iron transfusions as well as blood transfusion. Despite which, her hemoglobin remained low, 7.3gm/dl. She was fatigued, but denied abdominal pain, black stool, vomiting blood, fevers or chills. She had an upper endoscopy that was unremarkable as […]
Abstract Number: 598
Hospital Medicine 2020, Virtual Competition
Case Presentation: 47-year-old male veteran presented with one-month history of intermittent left-sided abdominal pain, vomiting, constipation and melena. Abdominal X-ray revealed small bowel obstruction. CT scan of the abdomen and pelvis with contrast revealed multifocal masses involving proximal to mid-small bowel with small bowel obstruction secondary to the mass at the level of jejunal and […]
Abstract Number: 622
Hospital Medicine 2020, Virtual Competition
Case Presentation: 47-year-old African American incarcerated male presented with headache, new seizures, and blurry vision. Spinal fluid showed high protein, lymphocytes, mildly elevated adenosine deaminase, and low glucose. AFB, bacterial, fungal and viral studies were negative. MRI revealed severe basilar meningitis with enhancing nodular density. RIPE (Rifampicin, Isoniazid, Pyrazinamide, Ethambutol) was started, followed by RI […]
Abstract Number: 629
Hospital Medicine 2020, Virtual Competition
Case Presentation: This is a 49 year old female, with no significant medical history, who started having intermittent fevers, night sweats, and fatigue 11 months prior. She reported a temperature of 100.4°F with cough and rhinorrhea, diagnosed as bronchitis with an elevated CRP of 40 mg/L. She reported some improvement with azithromycin but continued to […]
Abstract Number: 734
Hospital Medicine 2020, Virtual Competition
Case Presentation: A 64-year-old Middle-Eastern man with a history of rheumatic heart disease status post mechanical mitral Starr-Edwards ball-in-cage valve (in 1968), atrial flutter on coumadin and prior ischemic stroke with residual blindness presented with 4 days of “bloody” urine. Physical exam was significant for scleral icterus, an unchanged holosystolic murmur, and the observation of […]
Abstract Number: 798
Hospital Medicine 2020, Virtual Competition
Case Presentation: A 55 year old Caucasian male presented to the emergency department with two weeks of palpitations and chest pain. He experienced intermittent chest pressure and palpitations that were worse while lying down. He denied recent change in weight, skin changes, or SOB. He had a 45 pack-year smoking history, having quit two years […]
Abstract Number: 825
Hospital Medicine 2020, Virtual Competition
Case Presentation: A 56 year-old man with a history of psoriasis on adalimumab, coronary artery disease with prior stents, presented with chest pressure, dizziness, and dyspnea on exertion after noticing three days of melena and crampy abdominal pain. He denied nausea, vomiting, hematemesis, or bright red blood per rectum. Other than taking aspirin 81mg once […]