Colon CA Screening – 11.14.2013
Dr. Roys lecture available here.
LFT Abnormalities I – 07.17.13
Dr. Lowe gave a great lecture on LFT abnormalities. Find his slides here.
GI Bleed – 7.12.13
Find here Dr. Huang’s slides for noon conference on GI bleed.
Recurrent C. difficile or Ulcerative Colitis flare?
A case of a 24yo woman with rapidly progressive ulcerative colitis and recurrent C. dif was presented. We reviewed how to diagnose C. dif (ELISA vs. PCR vs. culture) and available treatments, including a new antibiotic fidaxomicin. ISDA guidelines were also reviewed. Cost of various treatment regimens were mentioned: metronidazole course ~$100; vancomycin course ~$200; […]
Acetaminophen Toxicity
34 yo M with DM, HTN, DVT on coumadin presenting with a perirectal abscess and was subsequently found to have markedly elevated LFT’s (ALT – 3300, AST – 380). On further history, it was found that the patient was taking Vicodin (acetaminophen + hydrocodone) multiple times daily due to the rectal pain. Patient was diagnosed […]
LLQ Pain with a Twist
A young 24 year old gentleman with history of GERD on omeprazole presented with worsening LLQ pain for the past month. Described as “deep and aching”, it was non-radiating and exacerbated with meals. Additionally, he had associated nausea and non-bloody emesis with resolved non-bloody loose stools over the past week prior to admission. He denies […]
My Bowels Are Misbehaving
Today’s discussion focused on a 54 year old woman with hypertension and chronic pelvic pain s/p TAH/BSO presenting with lower abdominal cramping with associated bloody diarrhea. Pertinent findings were explored, including risk factors and dietary regimen to recurrence of her symptoms or review of constitutional symptoms. The case continues to where she recalls being able […]
That’s Tough to Swallow!
How do we go about exploring the world of dysphagia? One start was to review a case of a 49 year old gentleman with a history of polysubstance abuse (heroin, alcohol) who presented with several days of dysphagia with more difficulty with solids. Further investigation revealed that he had no trouble initiating his swallowing, but […]
Elderly Woman with Periumbilical Pain
Today’s case involved a 77 year old F with CAD s/p CABG 2008, atrial fibrillation, HTN, DMII who presented with 1 week of periumbilical pain with associated nausea and emesis. Additionally, she was found to have a monocytosis as well as pre-renal azotemia. Although a poor historian, residents were able to delve into potential differentials […]
Autoimmune Hepatitis
41 y.o. man presenting with new onset of jaundice. His labs, including high bilirubin were consistent with alcoholic hepatitis. However the patient vehemently denied being a heavy drinker. Serum ANA and anti-smooth muscle antibody both came back positive and the diagnosis of autoimmune hepatitis was entertained. Here are some links for your perusal: Review of […]