Background: D-dimer is clinically useful for its high sensitivity and negative predictive value as a useful “rule out” test for venous thromboembolism. Nevertheless, the D-dimer assay is not specific and often elevated in states of systemic inflammation or illness.Stasis of blood flow, Endothelial injury, and hypercoagulability are the tenets of thrombus formation. When any one [...]

Case Presentation: A 43 year-old man with history of alcohol abuse presented with progressive shortness of breath. He was found with severe pneumonia and subsequently developed cardiac arrest. Initial EKG suggested anteroseptal infarct, age undetermined; troponin was elevated with a peak of 0.188 ng/mL (normal <0.031 ng/mL). A left heart catheterization (LHC) revealed non-obstructive coronary [...]

Case Presentation: This is a 21 year old male with no significant past medical history presenting with shortness of breath and fever.  Five days prior to presentation, he noted sore throat, fevers, and heart burn so he presented to an acute care clinic. He had a positive rapid strep screen, so he was given azithromycin [...]

Case Presentation: A 68 year-old female with history of abdominal hysterectomy complicated by post-operative lower extremity deep vein thrombosis (DVT) and prophylactic inferior vena cava (IVC) filter placed prior to past knee replacement surgery now presenting to the hospital with severe right lower extremity pain and swelling impairing her ability to ambulate. On physical exam, [...]

Case Presentation: A 62-year-old male with past medical history of type 2 diabetes mellitus, coronary and peripheral arterial disease, heart failure with reduced ejection fraction, history of peripheral arterial embolism, history of stroke, vascular dementia and hypertension who presented with sudden onset of shortness of breath associated with cough and chest pain for one day. [...]

Case Presentation: A 74-year-old female with a past medical history of chronic pulmonary emboli, left ventricular heart failure, and hypertension presented with shortness of breath on exertion and bilateral lower extremity edema for one week. On examination, she was found to have jugular venous distention, crackles in bilateral lung bases, and 3+ pitting peripheral edema. [...]

Case Presentation: Our patient is a 35-year-old male with a history of hypertension who was transferred from an outside hospital (OSH) for renal vein, and inferior vena cava (IVC) thrombosis. A month prior to presentation to the OSH, he had developed acute, right-sided flank pain with nausea. At the OSH, he was diagnosed with nephrolithiasis, [...]

Case Presentation: A 32-year-old male with no significant past medical history presented to the emergency department with a 3-day history of anorexia, fever, and a rash after returning from a trip to Colorado. Additionally, he endorsed an 8-pound weight gain and dyspnea on exertion.Upon presentation, he was febrile, tachycardic and had a diffuse targetoid rash [...]

Case Presentation: A 34-year-old Caucasian lady with metabolic syndrome and hypertension presented with a sudden onset 10/10 right lower extremity pain associated with numbness and inability to ambulate. Vital signs were stable. On examination, her right lower extremity was pale, cold and pulseless. Her laboratory tests including hypercoagulable workup were normal. A CT aortogram with [...]

Case Presentation: Introduction: Renal cell carcinoma (RCC) is classically associated with the triad of abdominal pain, hematuria, and a palpable mass, but its variability in clinical presentation has earned it the label of “internist’s tumor” (1,2). Liver dysfunction has been observed as a result of metastatic disease and a non-metastatic paraneoplastic syndrome called Stauffer’s syndrome [...]