Case Presentation: A 28-year-old female with a medical history of lupus nephritis, chronic kidney disease (CKD) stage 4, and chronic anemia presented with progressive dyspnea on exertion, easy bruising, and a presyncope episode. She denied any fever, recent illness, diarrhea, vomiting, sick contacts, or changes in medication. On arrival, the patient was hemodynamically stable. Laboratory [...]

Case Presentation: A 63-year-old female with a history of laryngeal cancer presented with upper abdominal pain, nausea, and fatigue. Labs showed a white blood cell count of 41.5 × 10^9/L, hemoglobin of 10.1 g/dL, platelet count of 162,000/µL, and absolute neutrophil count of 9.97 × 10^9/L, with basophilia (1.0 k/µL). Peripheral blood smear had circulating [...]

Case Presentation: A 33-year-old male with sporadic alcohol use presented with acute epigastric pain. Acute pancreatitis was diagnosed based on abdominal pain, elevated lipase, and imaging findings of pancreatic inflammation. Initial management included intravenous fluids and pain control. During his hospitalization, he developed acute transaminitis. An abdominal ultrasound revealed cholelithiasis without biliary or pancreatic duct [...]

Case Presentation: A 64-year-old man with a history of apical hypertrophic cardiomyopathy and nonobstructive coronary artery disease (CAD) presented with acute onset non-radiating exertional chest pain localized to the precordium. His symptoms had progressed to the point of occurring even at rest. On arrival, his vital signs included a blood pressure of 112/65 mm Hg, [...]

Case Presentation: A 22-year-old female with PMH of TBI with resultant hydrocephalus s/p VP shunt placement and borderline personality disorder presented with three weeks of progressively worsening abdominal pain. She also reported a new onset of vaginal bleeding for 3 days, which was different from her usual amenorrhea secondary to IUD placement. The exam was [...]

Case Presentation: A 54-year-old man with history of type II diabetes mellitus and hyperlipidemia presented to the Emergency Department with 6 weeks of generalized weakness. On arrival, he was mildly tachycardic but otherwise stable. Physical examination was most notable for diffuse proximal muscle weakness in the bilateral upper and lower extremities. Pertinent laboratory studies showed [...]

Case Presentation: 42-year-old female with past medical history of type 1 diabetes mellitus complicated by recurrent diabetic ketoacidosis (DKA), coronary artery disease (CAD), peripheral arterial disease (PAD), and blue toe syndrome (BTS) complicated by recent amputations of her right 1-2 toes, presented to an outside hospital (OSH) in DKA. She was also septic with methicillin-susceptible [...]

Case Presentation: A 62-year-old man presented to the emergency department with chest pain and dyspnea after recently driving from Michigan to Florida. In the ER, he was hypertensive and tachypneic with normal saturations. EKG showed sinus tachycardia with a classic S1Q3T3 pattern. Labs revealed an elevated D-dimer and troponin. CTA chest revealed a large saddle [...]

Case Presentation: A 73-year-old female, bedbound, nursing home resident with a medical history of ESRD on dialysis, diabetes and hypertension, presented complaining of body aches, malaise, chills and cough. She was afebrile with normal range vitals. CBC showed a WBC of 21.8 with neutrophil predominance. CXR without focal pulmonary findings and urinalysis was negative for [...]

Case Presentation: A 56-year-old man with type 2 diabetes and hypertension presented to the ER with uncontrolled blood sugars, intermittent nausea, vomiting, fevers, and a 15-pound unintentional weight loss over one month. He was recently hospitalized with similar symptoms, started on insulin, and evaluated for fevers with negative blood and urine cultures, which were attributed [...]