Noon Report from a few weeks ago!

We discussed the case of a middle aged man with history of LTBI who presented with chronic episodic dizziness associated with syncope, chronic unintentional weight loss and fatigue, found to have a new systolic murmur on exam, with EKG showing bradycardia, low voltages, while the echocardiogram showed new diastolic dysfunction, and significant septal thickening. The discordance between echocardiogram showing LV hypertrophy without evidence of increased voltages on EKG increased suspicion for infiltrative process within the heart, leading to a diagnosis of cardiac amyloidosis.

Today we had a pt present with significant BL periorbital edema and a facial & neck rash that was ultimately diagnosed with dermatomyositis

Today we talked about a pt who presented with bulbar weakness who required intubation and ultimately a tracheostomy due to ingestion of black tar heroin c/b botulism

Today we had a patient with recently diagnosed syphilis who developed acute hearing loss 2/2 otosyphilis. A key learning point is that CSF studies may be bland and if the clinical picture is concerning for neurosyphilis, you should still treat

Today we discussed a case of a young woman with Lupus, Lupus Nephritis leading ESRD with recent transition from HD via AV Fistula to Peritoneal Dialysis, who presented with peritonitis with course complicated by afib RVR s/p dilt/metop w/ associated hypotension/bradycardia concerning for cardiogenic sock, found to have with new RV dilation, severe TR, and new HF. She was diagnosed with high output heart failure, AV access was ligated, with reversal of HF and TR!

Today we had a patient with a rash affecting palms and soles. We discussed the differentials for a rash affecting palms and soles and reviewed some less known caveats to the management of syphilis

Today, we had a case of Extranodal NK/T Cell Lymphoma that caused epistaxis requiring ICU monitoring. We reviewed how to manage epistaxis urgently!

Hi all, today, we had a case of lupus-induced protein losing enteropathy. Remember that protein losing enteropathy should be a warning sign to look for some underlying process!

Today we discussed the case of a young woman with history of hypothyroidism who was unhoused and not taking medications for 2 months, presenting with subacute onset fatigue, with periorbital and bilateral lower extremity edema and lower extremity hyperpigmentation, found to have profound hypothyroidism vs mild myxedema coma.

We also discussed a MKSAP question on management of intracranial hemorrhage, as review of American Heart Association’s guidelines for management of hypertensive emergency.

Today, we had an HIV-negative patient who was likely immuncompromised from EtOH cirrhosis who presented as a trauma after an unwitnessed fall with AMS, later found to have Cryptococccal meningitis!