Background: Fracture Liaison Services (FLS) are traditionally outpatient-based and led by orthopedists or endocrinologists. In the United States, over 1 million patients are hospitalized yearly with osteoporotic fractures and internal medicine hospitalists are frequently involved in their co-management. Purpose: Internal medicine hospitalists have an integral role in the prompt recognition and early treatment of patients [...]

Case Presentation: A 14-year-old male presented to an emergency department with 6 days of left thigh pain and inability to bear weight following a fall from bed. Associated symptoms included nausea, diaphoresis and weakness. Review of systems revealed pallor, easy bruising and yellow eyes. history was negative except for developmental delay, described as auditory processing [...]

Case Presentation: A five-year-old boy with autism presented to the hospital with two-months of fatigue, lower extremity pain, and a petechial rash. Review of systems was notable for a two-kilogram weight loss, intermittent gingival bleeding and refusal to walk for one week. On admission he was afebrile with a heart rate of 160 beats per [...]

Case Presentation: A 43-year-old male with roux-en-y gastric bypass fourteen years ago with complications and multiple adhesions, hiatal hernia associated with nausea and vomiting, and subsequent small bowel resection last year, started to experience cognitive changes and short-term memory loss. He has also experienced problems with balance, generalized weakness, and unintentional 60-pound weight loss. His [...]

Background: Nocardiosis is a rare but potentially severe infection that can affect the immunocompromised as well as the immunocompetent population. It presents as a localized or disseminated infection, most commonly introduced through the respiratory trac. A significant amount of time is often needed to establish a diagnosis of nocardiosis, which has been reported to be [...]

Case Presentation: 19 month old female with a history of unspecified T- cell immunodeficiency presented with a 10 day history of cough, fatigue, and persistent fevers. The patient had just returned from Mexico and reportedly was diagnosed with influenza there. Previously the patient had been on Bactrim prophylaxis, but ran out of it while in [...]

Background: Anemia is common in patients with HF with a prevalence ranging from 10-40%. Studies have shown that these patients have worse outcomes compared to those who don’t. The most common etiology remains iron deficiency and the updated 2017 HF guidelines state that for those patients who are diagnosed with iron deficiency anemia, intravenous iron [...]

Case Presentation: Case presentationA 47 yo female with a history of hypertension, obesity, and prediabetes presented to the emergency department of a community hospital with a 2 week history of a nonproductive cough and generalized weakness. Her chest x-ray showed bilateral patchy airspace opacities. Chest CT PE protocol was negative for pulmonary embolus, but showed [...]

Case Presentation: A 73-year-old Caucasian male presented with worsening fatigue and dyspnea for several days. His comorbidities included remote history of essential thrombocytosis controlled with aspirin, hypertension, chronic kidney disease, and mitral valve repair. He was admitted to the medical ICU for acute hypoxic respiratory failure requiring mechanical ventilation. His physical exam was remarkable for [...]

Case Presentation: A 51-year-old African American Female with PMHx of sickle cell trait, vitiligo (developed 5 years ago), T2DM, HTN, unspecified seizure disorder who presented with altered mental status and found to have severe pancytopenia. She presented hemodynamically stable with a physical exam notable for: pale conjunctiva and diffuse skin hypopigmentation consistent with vitiligo. Medications: [...]