Case Presentation: A 55-year-old male with a history of coronary artery disease, left ventricular (LV) mural thrombus, tobacco use, and recent thalamic, splenic, and renal artery infarcts, presented with two weeks of worsening pain and cyanosis of his left third and fourth toes, associated with claudication. He denied numbness or loss of strength. He denied [...]

Case Presentation: A 68-year-old man presented with dizziness, blurry vision, and leg paresthesias for one week, which started after a bout of gastroenteritis. Past medical was notable for an MCA stroke at age 40 with residual left-sided weakness. He was a never-smoker and had no risk for carbon monoxide exposure. On exam, patient had a [...]

Case Presentation: A 62-year-old female with a history of polycythemia vera presented to urgent care with swelling, redness, and pain over her right foot and ankle. She denied any trauma or insect bites. She was diagnosed with cellulitis and treated with intravenous Ceftriaxone for 3 days with minimal improvement. She continued therapy with oral Cefpodoxime, [...]

Case Presentation: A 56-year-old-male with hypertension, diabetes mellitus, chronic kidney disease (CKD) stage 3 presented with a 6-month history of intermittent lower extremity swelling and a 3-week history of scrotal and abdominal swelling. 9 months prior, he was noted to have worsening renal function and nephrotic range proteinuria (13g) prompting two renal biopsies which demonstrated [...]

Case Presentation: An 80-year-old woman with a history of hypertension, pre-diabetes, chronic kidney disease (stage 3b), and remote ischemic stroke without residual deficits presented to the emergency department complaining of several hours of epigastric discomfort and malaise. An EKG revealed >1 mm ST segment elevation in leads V4-6 (Fig. 1). The troponin I was elevated [...]

Case Presentation: A 72-year-old man with hypertension and tobacco use presented to the emergency room with three days of nausea, vomiting, substernal chest pain, and thoracic back pain, following weeks of worsening vertigo. He also described a year of progressive tinnitus, diplopia, unsteady gait, and restless legs. Vital signs were stable. Physical exam revealed bilateral [...]

Case Presentation: A 55-year-old female with hypertension presented to the Emergency Department with bilateral lower extremity rash. Five days prior, she developed fatigue and small red spots on her distal legs which progressed to pruritic, raised, palpable lesions. Over-the-counter steroid cream reduced the pruritus, but the rash spread proximally, prompting presentation. She was hypertensive with [...]

Case Presentation: A 56 year-old man with heart failure with preserved ejection fraction, aphasia and right-sided weakness from prior strokes presented with two days of difficulty with speech and ambulation. His vital signs were normal except for an oxygen (O2) saturation of 94% on 6 liters. On exam he was somnolent but able to follow [...]