Background: ACGME Milestones and Entrustable Professional Activities (EPA) have emerged as benchmarks for the professional development of house staff. Residents must demonstrate expertise in these patient care activities in order to progress in training, and thus, programs will require tools for direct observation in order to evaluate these skills. These tools must evaluate milestone‐specific performance […]

Background: Postmyocardial Infarction Syndrome (PMIS), also called Dressler syndrome or Post-pericardiotomy Syndrome, refers to a heterogeneous group of autoimmune-mediated conditions of pericardial, epicardial and myocardial inflammation following myocardial infarction. Generally considered to be rare in the reperfusion era, the features and risk factors of PMIS are less well characterized in the contemporary era. This study […]

Background: National data document that hospital medicine groups frequently lack representative diversity in terms of race, ethnic background and gender. This diversity gap further expands with career development and promotion. Traditional physician hiring strategies are susceptible to elements of bias that may contribute to these disparities. Purpose: To design and implement a structured process for […]

Case Presentation: A 59‐year‐old man with no medical history was referred for admission from a rheumatology clinic where he presented with night sweats, nonproductive cough, exertional dyspnea, nausea, decreased appetite, and loose stools. He also noted raised nodules on his fingers and elbows bilaterally. He was in his usual state of health until 10 months […]

Case Presentation: A 60 year old man with a prior history of cutaneous sarcoidosis was admitted to the hospital with fatigue, myalgias, fever, and hypotension. His physical exam revealed a maculopapular erythematous rash on his trunk and bilateral lower extremities. Of note, three weeks prior to his presentation, he was treated with a ten day […]

Case Presentation: A 72‐year‐old‐man with hypertension and right hip pain presented with sudden presyncopal symptoms while seated. He was tachycardic and hypotensive and was noted to have creatinine 4.7 mg/dL (baseline 0.9 mg/dL), potassium 4.6 mEq/L, calcium 6.3 mg/dL, phosphate 6.6 mg/dL, and alkaline phosphatase 1,138 U/L with normal gamma‐glutamyl transpeptidase. Exam was notable for […]

Case Presentation: A 45-year old female smoker with a history of asthma presented to our institution with an acute episode of dyspnea after being outdoors. On arrival, she was noted to be hemodynamically stable with oxygen saturations of 88% on room air. Her exam was significant for respiratory distress by evidence of tripod position, tachycardia, […]

Case Presentation: A 57-year old man was found down at home one day prior to admission. Three days prior, he experienced intermittent “stabbing” chest pain and dizziness. Past medical history was significant only for multiple sclerosis treated with Copaxone. On admission, he was afebrile, heart rate 113bpm, blood pressure 104/71 mmHg, respiratory rate 19 breaths […]

Case Presentation: Patient is a 62 year-old morbidly obese male (BMI 56), chronic obstructive pulmonary disease (COPD) on 4L of Nasal Cannula (NC) O2 at home, heart failure with preserved ejection fraction, who presented complaining of acute migratory left shoulder pain that radiates to his L ribs and now to the anterior chest. Pain is […]

Case Presentation: Drug induced hypersensitivity syndrome (DIHS/DRESS) is a severe reaction to an identifiable drug, manifesting as a rash, eosinophilia, lymphadenopathy, fever and frequently internal organ involvement. Though recovery is often achieved with early identification and withdrawal of the offending agent, mortality can reach 5-10% due to resulting fulminant hepatic failure, multiorgan failure, myocarditis or […]