Background: Up to 12% of hospitalized patients require high dose parenteral thiamine treatment to prevent Wernicke’s Encephalopathy, a devastating and easily preventable neurologic disorder that can lead to death. Despite the fact that it is as simple and relatively inexpensive therapy with no known side effects, high dose thiamine continues to be underutilized. Attempts to […]

Case Presentation: An 82‐year‐old woman came to the emergency department with pleuritic chest pain, cough, and fever. On arrival, she was found to have aphasia and right‐sided hemiparesis. Her family noted that she was normal just hours before. CT scan and MRI of her brain demonstrated only chronic ischemic changes consistent with her previous lacunar […]

Case Presentation: A 64‐year‐old man with coronary artery disease, type 2 diabetes, and stage 3 chronic kidney disease (baseline creatinine, 1.7) was admitted for worsening renal failure noted routinely (creatinine 6.2, BUN 70). His only symptoms were malaise and lethargy. He denied urinary changes, new medications, or exposures. Chronic medications were omeprazole, allopurinol, amlodipine, lisinopril, […]

Background: New Mexico has the highest number of alcohol-related deaths in the country, a title held since 1981. Nationally 1 in 10 deaths in working-aged adults are alcohol-associated whereas in New Mexico the ratio is 1 in 6 deaths. About 130,000 New Mexicans report alcohol dependence or abuse within the past year, but only 3% […]

Case Presentation: A 71‐year‐old woman with a medical history significant for hypercholesterolemia and COPD presented to the hospital with dyspnea and bilateral lower‐extremity edema for a few days. She was recently diagnosed with stage I pancreatic cancer treated with resection and had completed 4 cycles of gemcitabine. Medications on admission included simvastatin, albuterol, and fluticasone/salmeterol […]

Background: Prevalence of alcohol use disorder (AUD) on inpatient medicine wards exceeds 40%. Only 50% of these patients develop alcohol withdrawal, of whom only 5-20% develop complicated alcohol withdrawal syndromes (AWS) that warrant treatment and monitoring. Overutilization of the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) scale is well-reported in the literature. CIWA-Ar […]

Case Presentation: A 29 year old female presents with one week of sudden onset double vision. She reports accompanying dark spots in her vision, photosensitivity, and some unsteadiness with walking. The patient’s friend noted that her eyes were “crossed” the morning of admission. Past medical history is significant for alcohol abuse and anxiety with a […]

Case Presentation: A 58-year-old Caucasian woman with HIV on HAART, hyperthyroidism with radioiodine ablation, Hepatitis B and C, past IV drug use, former smoker, HTN, and HLD, initially presented with chest pain and was found to have NSTEMI. She underwent cardiac catheterization, which revealed 90% stenosis of mid-LAD and had a drug-eluting stent (DES) placed. […]

Case Presentation: 39-year-old male with history of previously treated TB meningitis 15 years ago, chronic hydrocephalus who received endoscopic third ventriculostomy few months ago, presented again with headaches and was found to have hydrocephalus. Patient received Ventriculoperitoneal shunt placement and CSF was obtained after the procedure. CSF studies showed (216-WBCs lymphocytic predominant fluid 81 %), […]