Endocrine Emergencies – 7.29.13
See Dr. Lee’s slides on Endocrine Emergencies.
Hyperglycemic Crisis – 7.15.13
Dr. McDonnel gave a great lecture on hyperglycemic crisis. Find her slides here.
Hypoglycemia – 7.3.13
Dr. Alexanian spoke about hypoglycemia in the hospital setting. Find her slides here.
Abbreviation Monday – HHS and KPD
We discussed a case of a 58 yo M who presents with altered mental status who was found to have HHS, with a glucose of 1018. His presentation is consistent with a subset of Type-II DM, known as Ketosis-Prone Diabetes (KPD). This subset often occurs later in life and a presentation of HHS/DKA can be […]
Rare complication of a common disease
Today’s case discussion was of a 42 yo M who presented multiple times to the ED for evaluation of persistent L thigh pain and swelling. It started acutely while he was walking on a treadmill about 2 mos ago and has been constant since then. Reports subjective fevers. Due to the severity of the pain, […]
Classic Grave’s hyperthyroidism with anterior mediastinal mass
Stimulating discussion at Intern Report of a case of classic Grave’s hyperthyroidism. 21 yo F presenting with 40 lbs weight loss, palpitation, SOB/DOE, neck swelling, diarrhea, irregular menses for 6 months. On further evaluation was found to be hyperthyroid per labs and diagnosed with Grave’s disease (TSI/ thyroid stimulating immunoglobulins- elevated). She was also found to have […]
B-cell Lymphoma in the guise of Multiple Myeloma
A very intellectually stimulating discussion of a 54 yo homeless M presenting with acute on chronic R hip pain. More detailed history-taking reveals constitutional symptoms of progressive fatigue, fever with sweats, polyuria and constipation. On evaluation, serum calcium level was 18.8 (after correction), AKI and on MRI+CT multiple bone lesions (spine, R hip) and a splenic lesion as […]
Dr. Doerr’s Diagnostic Dilemma
28 y/o M w/ hx of Bipolar (noncompliant with lithium) who presents with cc of myalgias and itchy painful penile rash over the last few days. Initial FSG 600s. On ROS pt noted to have polyuria, polydipsia over the last few weeks and weight gain ~ 80lbs over the last year. Has maternal history of […]
Multiple Problems
67 y/o M presents with back pain, generalized fatigue, anorexia, nausea & vomiting. Exam reveals: altered mental status and profound volume depletion. Labs reveal normocytic anemia, acute renal failure, hypokalemia 2.9, hypercalcemia to 14 and hypergammaglobinemia. Imaging reveals lytic lesions in T10. Pt on initial presentation was noted to have severe hypercalcemia with resultant diabetes […]
Thyrotoxicosis presenting as Heart Failure
61 y/o Male who was treating a “fast HR” for years with Chinese herbals presents with history of increasing lower extremity edema and difficulty breathing. History significant for NYHA Class II/III symptoms and weight loss of 30lbs. Exam significant for cachexia, lid lag, pulmonary congestion, tachycardia, elevated JVP, possible pulsatile liver, pitting edema extending up […]