Background: Fracture Liaison Services (FLS) are traditionally outpatient-based and led by orthopedists or endocrinologists. In the United States, over 1 million patients are hospitalized yearly with osteoporotic fractures and internal medicine hospitalists are frequently involved in their co-management. Purpose: Internal medicine hospitalists have an integral role in the prompt recognition and early treatment of patients [...]

Case Presentation: A 61 year-old woman presented with unbearable weakness and muscle aches that progressed over the past two weeks. The patient was seen in clinic the day prior for these symptoms and overall lethargy to the point of inability to stand or walk. On examination, she had generalized weakness, dry skin, a flat affect, [...]

Case Presentation: A 58- year-old female presented with vomiting, dizziness, and a blood pressure of 80/60 mmHg. Laboratory: serum creatinine 3.1 mg/dl (baseline 1 mg/dl), BUN 34 mg/dl (baseline 10 mg/dl), corrected calcium 12.3 mg/dl, low PTH , normal 25-OH vitamin D, and normal PTH-related protein. Two months prior, serum calcium was normal and 25-OH [...]

Case Presentation: A 55-year-old woman with a remote history of renal transplant complicated by stage 4 chronic kidney disease (CKD) presented to the emergency room with a week history of progressive fatigue, fever, dry cough and exertional dyspnea. Outpatient medications were tacrolimus 2.5mg BID, mycophenolate mofetil 500mg BID, prednisone 5mg daily, and vitamin D 1000 [...]

Case Presentation: A 3-year-old immunized male, with a history of atopic dermatitis and anaphylactic dairy allergy, was brought to the ER due to refusal to bear weight for one month. There was no trauma, fevers, or recent sick symptoms. He had a severely restricted diet of potato products and breast milk. On exam, he was [...]

Case Presentation: A 29-year-old woman with a history of two first trimester losses, spontaneous hematoma and deep vein thrombosis was hospitalized for the management of acute anemia. Six weeks prior, she was hospitalized for a spontaneous right calf hematoma. Four weeks later, she was diagnosed with an unprovoked acute right popliteal vein thrombus and was [...]

Case Presentation: A 47 year-old African American male presented with lower extremity pain and swelling. Three weeks prior he started azilsartan/chlorthalidone for hypertension. A week later, pain and swelling of his right leg began, worsening with ambulation. He denied trauma or unusual physical exertion. Review of symptoms elicited a history of chronic bilateral leg cramps. [...]

Case Presentation: A previously healthy 7-month-old male infant was admitted after having a new onset 10-minute seizure. He was exclusively breastfed until 2 weeks prior to admission. His mother reported decreased oral intake since switching to formula and introducing solid foods. The infant had not been taking any vitamins.Physical exam: The patient was afebrile, alert, [...]

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 [...]

Background: Vitamin D (Vit D) is a fat-soluble vitamin that supports normal bone development and maintenance by increasing the absorption of calcium, magnesium, and phosphate, which are essential for bone mineralization. Vitamin D is commonly assessed through serum 25-hydroxyvitamin D (25(OH)D) levels, with sufficient levels defined as ≥30 ng/mL, and deficient as < 20 ng/ml. [...]