Background: Anemia is a risk factor for cognitive impairment as a result of reduced delivery of oxygen to the brain from low hemoglobin (Hb) levels. In ambulatory patients, mild anemia (Hb 10-12g/dL) has been associated with reductions in patients’ cognitive function [1–3]. In hospitalized patients it is standard of care to maintain Hb levels far […]

Background: Intravenous (IV) low molecular weight iron dextran is a safe and effective treatment for iron deficiency anemia (1). However, oral (PO) iron supplementation remains a preferred mode of iron repletion due to low cost and ease of administration. Unfortunately, the efficacy of PO iron varies due to differences in drug absorption and patient adherence. […]

Case Presentation: A 48-year-old female with spina bifida was admitted for sepsis secondary to sacral osteomyelitis. She improved with broad-spectrum antibiotics, and her antibiotic regimen was narrowed to Zosyn (piperacillin + tazobactam) to complete a 6-week course. On hospital day 12, discharge was delayed pending insurance approval of an air mattress for home. Three days […]

Case Presentation: A 75 year old woman with past medical history of hypothyroidism presented with weakness and the sensation of “large folds of skin” on the bottom of her feet. Pertinent physical exam findings included conjunctival pallor, nonspecific diffuse abdominal tenderness, and hyperpigmented macules of the dorsal finger tips and soles, which were also new […]

Case Presentation: A 76-year-old Chinese woman with history of cryptogenic cirrhosis (MELD-Na 25) presented to our hospital with 1 week of worsening jaundice, abdominal distension, and right upper quadrant pain. Cirrhosis was diagnosed by imaging on admission 2 months previously and presumed to be secondary to Hepatitis C infection due to antibody positivity. CT of […]

Case Presentation: A 38-year-old Hispanic female with chronic constipation, anemia and numerous transfusions secondary to uterine bleeding presented to the emergency department with a two-week history of worsening bilateral lower extremity ascending numbness and weakness extending to her abdomen causing her difficulty with walking. She reported blurry vision, headaches, difficulty breathing, and 24 hours of […]

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 […]

Case Presentation: We present a case of a 37-year-old female with a past medical history of cerebral palsy and iron deficiency anemia due to heavy menstrual periods who presented with right-sided leg weakness for a few hours. Upon the patient’s arrival to the emergency room a stroke code was called. A CT scan of the […]

Case Presentation: Few spider bites are medically significant. A 24-year-old African American woman presented with malaise, fever, nausea, and myalgias. She reported a sharp pain on her lower back the night prior that at first felt like burning before progressing to pain. Her initial vitals were T 101, HR 120, BP 141/117. Physical exam revealed […]

Case Presentation: A 52-year-old African American male with a past medical history of gastric ulcer presented to the emergency department with progressively worsening exertional dyspnea and fatigue over the past two months. Physical examination was significant for a heart rate of 105 bpm and icteric sclera. Pinprick and vibratory sensations over bilateral lower extremity were […]