Background: While understanding the cognitive contributions to diagnosis has become important, few studies have aimed to understand physician diagnostic reasoning in real-time. Using a case-based approach, we sought to: (a) characterize differences in diagnostic reasoning among hospitalists; and (b) identify factors associated with diagnostic accuracy. Methods: A total of 10 hospital medicine attending physicians from [...]

Case Presentation: An 80 year-old man presented with one day of confusion, worsened cough, and subjective fevers. He had a productive cough since emigrating from Mexico six months ago, but no complaints of dyspnea. He had a history of diabetes and stable angina for the past year. On presentation, he was tachycardic with a temperature [...]

Altered Mental Status in a Psychiatric Patient: A Case of Anti-NMDA Encephalitis Case Presentation: 29-year-old female with a history of Bipolar I Disorder, in remission off medication, presented to the Psychiatric Emergency Department with hyperactivity, insomnia, impulsive purchasing and audiovisual hallucinations for two weeks. The patient was admitted to psychiatry for treatment of mania with [...]

Case Presentation: A 24 year old male with a history of childhood asthma and COVID in 2021 presented to ED with worsening sore throat, fevers, tenderness of his mouth and gums, and mild lightheadedness. He was recently diagnosed with streptococcal pharyngitis and started on oral penicillin three days prior to presentation. He was on no [...]

Case Presentation: A 65-year-old woman with a history of early-stage breast cancer—was treated six years prior. She was subsequently admitted multiple times over the following years for pancytopenia, which was thought to be multifactorial—due to nonalcoholic steatohepatitis and auto-immune hemolytic anemia (AIHA). Therefore, she received a supportive blood transfusion, intravenous immunoglobulins, and rituximab for suspected [...]

Case Presentation: Our patient is a 64 year old gentleman with a history of prior cerebellar stroke who presented to the Emergency Department (ED) after being found unresponsive in his car by bystanders. On ED evaluation he was noted to be lethargic, able to follow commands but unable to recall what happened. Neurologic exam in [...]

Case Presentation: A 12-year-old healthy female presented for three weeks of abdominal pain, loose non-bloody stools accompanied by night sweats and an eight-pound weight loss. Initial exam was only significant for diffuse abdominal pain. An abdominal X-ray demonstrated a unique appearing paravertebral stripe which prompted a follow up MRI abdomen/pelvis. MRI imaging revealed a 5.8 [...]

Case Presentation: A 46 year-old man with bipolar disorder and hypertension presented to the emergency department (ED) with total body pain. He had been at the local airport when he had sudden onset total body throbbing sharp pain. He collapsed on the floor and a bystander called EMS who transported him to our ED. His [...]

Case Presentation: A 66-year-old male with history of type 1 Von Willebrand disease, colonic polyps, and gastric ulcer from naproxen use due to osteoarthritis presented with a 3-week history of lethargy and fatigue with walking short distances. He denied melena or hematemesis but did report consistent ibuprofen use for his osteoarthritis over the past few [...]

Case Presentation: 76 year old female with a history of COPD, Asthma, Allergic Rhinitis, and GERD presented to the Emergency Department for evaluation of worsening fatigue, dysgeusia and weight loss. Given these symptoms, the patient’s allergist referred her for COVID-19 testing. The patient denied any respiratory or GI symptoms, and review of symptoms was only [...]