Decision‐Making in the Face of Ethical Uncertainty

Case Presentation: A 51‐year‐old man with a history of depression and both oral hyperesthesia and stroke suffered during a recent dental procedure was admitted for profound weight loss, malnutrition, and constipation. During admission, he consistently [...]

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Okham's Razor Revisited

Case Presentation: A 14‐year‐old African American girl with no medical history presented to the emergency room (ER) with acute diffuse abdominal pain associated with nausea and vomiting. The workup included basic laboratory evaluation and abdominal [...]

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Vitamin D Toxicity: Rare or Underdetected?

Case Presentation: Case 1 is a 58‐year‐old man presenting with obtundation, fatigue, polydipsia, and polyuria of 3 weeks’ duration. Labs showed calcium (Ca) 15 mg/dL, creatinine (Cr) 1.78 mg/dL, and normal phosphorus, magnesium, SPEP, and UPEP. Intact [...]

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Adenocarcinoma of the Lung Presenting As a Skull Mass

Case Presentation: A 60‐year‐old, previously healthy woman presented with intermittent right‐sided numbness. She also had a lump on the left parietal scalp for a year with no symptoms. This was assessed outpatient and was adjudged [...]

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Terbinafine‐Induced Pustular Psoriasis: A Case Report and Literature Review

Case Presentation: A 67‐year‐old man presented with a 2‐week history of worsening diffuse body rash. The patient had initiated oral terbinafine 250 mg daily 1 month prior for toenail onychomycosis; he denied any other new medications. [...]

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A Perfect Storm: Percocet, Pinot, and Previous Bowel Surgery

Case Presentation: A 78‐year‐old woman with a history of small bowel obstructions with subsequent resections presented with a 3‐week history of progressive abdominal distention, escalating pain, and nausea. Her symptoms reached maximum intensity in the [...]

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A Sinister Tale of 2 Swollen Kidneys

Case Presentation: An 83‐year‐old woman with a history of invasive ductal breast cancer in remission status post lumpectomy and radiation presented with complaints of generalized weakness. Her vital signs were stable, and exam was remarkable [...]

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Spinal Cord Injury and Autonomic Dysreflexia: A True Medical Emergency

Case Presentation: A 64‐year‐old man with a history of quadri‐plegia at the C5–C6 level more than 25 years ago secondary to a motor vehicle accident presented with blisters on both feet and worsening positional hypertension. [...]

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Spontaneous Portal‐Systemic Shunt As Cause of Refractory Encephalopathy

Case Presentation: A 56‐year‐old white man was admitted with 3 days of worsening mentation refractory to increasing doses of lactulose. History included remote alcohol abuse, alcohol‐induced cirrhosis diagnosed after a sentinel variceal bleed, and chronic [...]

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Trichobezoars As a Cause of Upper Gastrointestinal Bleeding: A Case Presentation

Case Presentation: A 39‐year‐old African American woman presented with nausea, postprandial emesis, early satiety, abdominal distension/pain for 1 week, and 2 days of hematemesis. Physical exam revealed a diffusely distended, tender abdomen and a firm, [...]

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A Presentation of Dress (Drug Rash with Eosinophilia and Systemic Symptoms) Syndrome to the Medical Service

Case Presentation: This is a 51‐year‐old woman with a medical history significant for a seizure disorder diagnosed after she had a tonic‐clonic type seizure at age 16. She was treated with phenytoin, but this was [...]

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Hereditary Adult‐Onset Alexander Disease

Case Presentation: A 47‐year‐old white man with a history of alcohol abuse was transferred to our hospital with loss of consciousness and subsequently intubated en route for airway protection. His medical history was unremarkable. On [...]

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Tissue Is the Issue!

Case Presentation: Our patient is a 42‐year‐old African American woman with a significant history of a locally advanced ductal cancer of left breast (T2N1M0) after a modified radical mastectomy 1 year earlier. She also received [...]

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The Impact of Interdisciplinary Anticoagulation Safety Rounds at a Large Urban Teaching Hospital

Background: The Anticoagulation Safety Taskforce established a comprehensive Anticoagulation Safety Program over the last 2 years with the overall goal of reducing harm surrounding the use of the 3 most commonly used anticoagulants—heparin, warfarin, and [...]

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