Case Presentation: A 64 year old man with a history of membranous nephropathy on tacrolimus and recent cerebral arteriovenous malformation (AVM) repair, with stent placement seven months prior, presented to the emergency room with one day of progressive lethargy, frontal headache, photophobia, and confusion with subjective fevers and nausea.His vitals on presentation were significant for [...]

Case Presentation: A 54-year-old male was diagnosed with left renal pelvic, caliceal and ureteral transitional cell carcinoma(CA) 3 years before presentation. Patient had a history of transitional cell CA of the bladder that had extended to both kidneys despite local intervention. Patient underwent left sided nephroureterectomy 2 years later because of massive disease burden. Renal function [...]

Case Presentation: A 54-year-old African American woman presented with complaints of headache, blurred vision, and progressive bilateral leg swelling for the past week. This was her 4th visit to the hospital in 4 months with similar complaints. Medical history was significant for 10 years of refractory hypertension, many no-show visits, consequent chronic kidney disease stage IV, [...]

Background: Hypertension occurs in up to 75% of hospitalized patients. However, less than 1% have “hypertensive emergency,” defined as severely elevated blood pressure (BP) with end-organ injury. Current guidelines support emergent treatment of hypertensive emergency but recommend against immediate reduction of severely elevated BP in patients without end-organ injury (i.e., asymptomatic hypertension). Recent literature suggests [...]

Case Presentation: An 86-year-old woman with a history of hypertension on oral medications and chronic systolic heart failure presented to the hospital with chest pain and dyspnea. She was noted to be acutely hypertensive, tachypneic and hypoxemic. Physical exam revealed diffuse crackles, jugular venous distention and lower extremity pitting edema. EKG was consistent with an [...]

Case Presentation: A 56-year-old female presented to the ED complaining of epigastric abdominal pain for 5 days. Her past medical history was pertinent for a prior left upper extremity DVT. Her family history was positive for Factor V Leiden deficiency, for which she previously tested negative. She denied any pain radiation, nausea, vomiting, or change [...]