Case Presentation: A 54-year-old man presented with confusion, vomiting, and weakness. En route to hospital he received dextrose for a glucose of 40. Admitted to the ICU for severe metabolic acidosis. Past medical history included type 2 diabetes, depression and PTSD. Aside from tachycardia, smell of alcohol, and bilateral hand tremor, initial physical exam was [...]

Case Presentation: A 65 year old male with hypertension, type II diabetes, heart failure with recovered ejection fraction and emphysema with 30 pack year smoking history started to experience 15 pound weight loss and anemia 18 months ago. Initial presentation to PCP revealed elevated ALP 292U/L and Hemoglobin 12.6g/dL. Cancer screening with CT chest showed [...]

Case Presentation: A 34-year-old morbidly obese man with a history of recurrent headaches was admitted to the hospital with two months of rapidly progressive bilateral vision loss, weight gain, and lower extremities (LE) and scrotal swelling. An eye exam revealed severe papilledema in both eyes. Labs revealed brain natriuretic peptide 588 pg/ml and chest X-ray [...]

Case Presentation: An 80-year-old female with past medical history significant for atrial fibrillation on apixaban, coronary artery disease, heart failure with preserved ejection fraction, Grave’s disease s/p thyroidectomy on vitamin D, calcium and levothyroxine supplements, and diabetes mellitus presented with 1 week of malodorous urine and 3 weeks of auditory and visual hallucinations. She reported [...]

Case Presentation: Hypercalcemia can have adverse effects on the body. Rarely a sign in and of itself, its presence is characteristically associated with an underlying condition. There are usual suspects to consider in the differential but when workup for those return unremarkable, it becomes a challenge to find the underlying etiology.An 80-year-old female with a [...]

Case Presentation: 52-year-old male presented with six-week history of unintentional weight loss, decreased appetite and non-radiating dull suprapubic pain. Review of systems was notable for constipation, polyuria, polydipsia, nausea, and left leg swelling. No family history of cancer or blood dyscrasias. Physical examination revealed blood pressure- 194/114 mmHg, heart rate -105, distended abdomen with hypoactive [...]