Background: Tobacco use is the most widespread preventable cause of cancer and is linked to 30% of cancer-related deaths.(1) Many smokers want to quit but are unsuccessful; tools such as nicotine replacement therapy (NRT) products can increase quit rates by 50-60%.(2) While smoking cessation is the ideal way to combat tobacco-related diseases, screening for diseases [...]

Case Presentation: A 90-year-old man with a history of left upper lobe pulmonary nodule on prior imaging presented with dark tarry stools, fatigue and syncope. He had not had an EGD or colonoscopy done in about 10 yrs. Five months prior to this presentation, a 2.4 cm left upper lobe pulmonary nodule suspicious for neoplasm [...]

Case Presentation: A 45 year-old Cambodian female with no past medical history presented to the clinic with a mild cough. Her medical history was notable for never smoking, occasional alcohol use, and no recreational drug use. She had no known occupational exposures and no family history of malignancy. Initial treatment for gastroesophageal reflux disease and [...]

Case Presentation: A 77 year old female who had a diagnosed primary gastric adenocarcinoma at another hospital presented to the emergency department with shortness of breath. A chest x-ray was done which showed a large left-sided pleural effusion (Figure 1). An ultrasoundguided thoracentesis was done and the pleura was positive for metastatic adenocarcinoma, however the [...]

Case Presentation: A 70-year-old male with a past medical history of hypertension and diabetes was sent to the emergency room by primary care physician because of persistent hypokalemia while taking oral potassium supplements. Patient reported generalized weakness, low back pain, thirty-pound weight loss and poor appetite for a few months. He smokes one packet of [...]

Case Presentation: An 80-year-old female with a history significant for breast cancer status post mastectomy with chemo/radiation therapy and phenytoin-induced liver injury in 2013 presented with nine months of weakness, weight loss, and 2-3 month history of confusion, memory loss, and widespread tremors, suspicious for focal status epilepticus. Workup revealed hyponatremia (135 mmol/L) and elevated [...]

Case Presentation: A 68 year-old-woman with right upper lobe non-small cell lung cancer on chemotherapy presented with shortness of breath. A CT scan of the chest prior to admission revealed a right hilar mass encasing and narrowing the distal superior vena cava (SVC). Her exam was notable for distended neck veins and diminished breath sounds [...]

Case Presentation: A 94-year-old woman with a history of atrial fibrillation (not on anticoagulation), coronary artery disease, and metastatic lung adenocarcinoma (on Osimertinib) presented following a syncopal episode, which was complicated by a left thigh hematoma. On admission, she was hemodynamically stable, although her bloodwork was concerning for disseminated intravascular coagulation (DIC) including a hemoglobin [...]

Case Presentation: A 59 year-old female with past medical history significant for chronic hyponatremia and tobacco use presented to the hospital with complaints of dyspnea and neck pain for 2 weeks. She reported blurry vision and swelling in her neck, face and axillae. Initial vitals were stable. Admission labs were significant for sodium 125, baseline [...]

Case Presentation: A 78 year old male with a history of atrial fibrillation, type 2 diabetes and former significant tobacco use, presented with a one month history of left sided neck pain. The pain was progressive and he subsequently developed left upper extremity swelling along with a rash involving the neck, left anterior chest and [...]