Case Presentation: A 32-year-old healthy female presented with right lower quadrant abdominal pain, hematuria, and easy bruising for four days. She denied prior episodes and family history. On physical exam, she had stable vital signs, gingival bleeding, and hemorrhagic papules on her hands [image 1] and lip. Her labs were significant for: hemoglobin 11 g/dL, [...]

Background: E-cigarette or vaping-associated lung injury (EVALI) was first reported in 2019 in the United States (1-2). Reported lung findings in this disease include acute respiratory distress syndrome, acute eosinophilic pneumonia, hypersensitivity pneumonia, and giant cell interstitial pneumonitis (3-5). Considering the additional reports of diffuse alveolar hemorrhage and hemoptysis (6-11), we obtained coagulation studies prior [...]

Background: Paracentesis is a commonly performed bedside procedure in hospitalized patients. It is often necessary for patients who are taking anticoagulant therapies and/or have disorders of hemostasis. Concerns about bleeding complications often lead to care delays, blood product transfusions, medication changes, and costly labs. Purpose: This study evaluates the safety and clinical outcomes for a [...]

Case Presentation: 59 year old female presented to the emergency department complaining of two weeks of atraumatic, painful bruising to her lower extremities, right shoulder, and lower back. She was unable to bear weight on her right lower extremity due to pain.  She denied any history of anticoagulant or antiplatelet usage, and denied any family [...]

Case Presentation: A 39-year-old male post-splenectomy due to hereditary spherocytosis presented with syncope, fatigue, fever and dark urine. He had associated tachycardia and fever. Physical exam was unremarkable. Labs showed an elevated lactate, creatinine, bilirubin, transaminases, and markedly elevated D-dimer. CBC was normal. He received IV fluid resuscitation and IV Rocephin. The patient subsequently desaturated [...]

Case Presentation: Our patient was a 29-year-old male with a past history of chronic marijuana use that presented to the hospital with an uncontrolled hemorrhage from his tooth. The patient tripped walking down the stairs and hit his face on a stair cracking his left upper second molar. He reported no other symptoms besides the [...]

Case Presentation: 28-year-old male with past medical history of recent nephrolithiasis presented with lower back pain, hematuria and upper extremity ecchymosis of 1 week duration. He denied any history of bleeding disorders, ingesting any anticoagulants, recent infections or drug usage. Upon work up, patient was found to have an INR (International Normalized Ratio) of > [...]

Case Presentation: 63-year-old female with past medical history of type II diabetes, Roux-en-Y bypass, alcoholic hepatitis, osteoarthritis of bilateral knees post-total left knee arthroplasty (2014), presented with acute left knee pain and new functional decline. She denied any trauma, fevers, or chills. Exam was notable for warmth over the joint, diffuse pain with palpation and [...]

Case Presentation: A 65-year-old woman with antiphospholipid syndrome (APLS), and history of multiple lower extremity deep vein thrombosis (DVT) and miscarriages, on warfarin presented with syncope, fall, and head-strike. She was found to have an acute subdural hematoma (SDH) in the interhemispheric fissure and a non-occlusive DVT in the left femoral vein. Initial labs showed [...]

Case Presentation: An 80-year-old man with prostate cancer and radical prostatectomy with an indwelling Foley catheter presented from his nursing home with three days of hematuria and a hemoglobin of 5.2 mg/dL (baseline 7-9 mg/dL). Initial vital signs were normal. Exam was significant for pink-tinged urine, copious melena, and no abdominal pain. A repeat hemoglobin [...]