A Painful Rash of Acute Onset

Case Presentation: A 47‐year‐old woman presented with 2 days of painful rash over her bilateral thighs and buttocks. Six days prior, ultrasonography had revealed bilateral lower‐extremity deep vein thrombosis, and she had received intravenous unfractionated [...]

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Cocaine Intoxication Mimicking Meningitis

Case Presentation: A 26‐year‐old woman was found unresponsive and surrounded by peritoneal dialysate. She was last known to be conscious 12 hours prior. Past medical history includes uncontrolled type I diabetes mellitus, hypertension, depression, schizoaffective [...]

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Paget‐Schroetter Syndrome: A Common but Forgotten Entity

Case Presentation: A 36‐year‐old healthy male presented with a 6‐hour onset of pain, swelling, and purplish discoloration of the left upper extremity after lifting weights at the gym. He denied any trauma to the shoulder [...]

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Recurrent Life‐Threatening Hyperkalemia without Electrocardiographic Changes

Case Presentation: We report a case of profound recurrent hyperkalemia with no associated EKG changes in an 84‐year‐old female patient with normal baseline renal functions. Her past medical history was significant for hypertension, CHF, pulmonary [...]

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A Rare Cause of Rectal Pain

Case Presentation: A 64‐year‐old male without a significant past medical history presented with a complaint of rectal pain. The pain was worse with bowel movements, and as a result the patient reported a fear of [...]

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The Forgotten “P“ in MUDPILES

Case Presentation: A 27‐year‐old woman, marginally housed, with a history of recreational carisoprodol (Soma) and acetaminophen (APAP)/hydrocodone use presented with abdominal pain and malaise. On physical exam, she was tachycardic and somnolent. Abdomen was soft [...]

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Lessons Learned from Delayed Diagnosis

Case Presentation: The patient was a 71‐year‐old Indian businessman with a history of coronary artery disease, diabetes, and hypertension who presents with weakness. Three days PTA, the patient flew from Bombay to San Francisco, where [...]

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Submassive Acute Pulmonary Embolism with Acute Pulmonary Hypertension and Right Ventricular Dysfunction: A Case Report

Case Presentation: An 88‐year‐old female with hypertension and no prior pulmonary disease presented with acute onset of dyspnea on exertion and chest discomfort. CT angiogram showed multiple acute pulmonary emboli as well as several chronic [...]

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Hypokalemia and Chronic Diarrhea Presenting as Gastrinoma: The Role of Endoscopic Ultrasound (EUS)–Guided Fine‐Needle Aspiration (FNA) in the Preoperative Diagnosis

Case Presentation: A 47‐year‐old male with a history of chronic diarrhea for 10 years presented with diarrhea and hypokalemia. Potassium was 2.4 mEq/L. Further workup was negative for malabsorption or infectious causes of diarrhea. Stool [...]

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Post‐Angioedema Attack Skin Blisters: A Unique Presentation of Hereditary Angioedema

Case Presentation: A 36‐year‐old male with a known history of hereditary angioedema presented to an outside hospital ER with acute respiratory failure requiring endotracheal intubation. The patient received 2 units of fresh frozen plasma after [...]

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Narcotic‐Induced Constipation in the Hospital Setting: The Role of Interdisciplinary Communication

Background: Narcotic‐induced constipation (NIC) is a common complaint among patients taking narcotics and significantly impedes optimal pain control and recovery. Its most feared and potentially fatal complication is fecal impaction with subsequent bowel perforation, Although [...]

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Management of Postoperative Pain in Elective Hip and Knee Arthroplasty Surgery

Background: Hip and knee arthroplasty surgeries are among the most painful surgical procedures, with half of patients reporting severe postoperative pain, Unrelieved postoperative pain is associated with diminished rehabilitation, delirium, disrupted sleep, and slower healing, [...]

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Morale Matters: Top 10 Keys to Happy Hospitalists

Background: Demand for hospitalists continues to rise. Despite reports of high overall provider satisfaction, hospitalist retention and recruitment remain challenging. Identifying specific issues most important to hospitalists may guide efforts to improve and sustain morale. [...]

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Strategies for Effective On‐Call Supervision for Internal Medicine Residents: The Superb/Safety Model

Background: Although supervision is central to resident education and patient safety, there is little to guide the use of effective supervision strategies. The aim of this study is to describe effective supervision for on‐call internal [...]

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Application of Long‐Term Care Principles in Acute Care: Comparison of Pressure Ulcer Rates by Case‐Mix Index Analysis

Background: The use of patient safety indicators such as pressure ulcer rate, allows institutions to monitor and compare their level of efficacy with other hospitals. Medicare and Medicaid have instituted quality measures and payment based [...]

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