Medicine and Health Sciences Commons^™

Pharmacist Pilot Project To Reduce Hypoglycemic Events On Internal Medicine Unit, Carly Barnes, Pamela Levine

Providence Pharmacy PGY1 Program at Providence Portland and Providence St. Vincent Medical Centers 2021

No abstract provided.

Overloadipine–Emerging Therapies To Treat Refractory Shock, Stephanie Barayuga, Irene Hendrickson

Providence St. Vincent Internal Medicine 2021

Introduction

Refractory vasodilatory shock develops from uncontrolled vasodilation and hyporesponsivenessto vasopressors. •Management of calcium channel blockers (CCB) toxicity can be difficult because it can result in refractory vasodilatory

Case Presentation

•21-year-old male with history of depression and prior suicide attempts presented after intentional ingestion of amlodipine (300 mg) and metformin (150 tablets of 1000 mg). •Presented with slightly altered mentation and hypotension, then quickly deteriorated and required intubation and high vasopressor requirements. •Transferred to PSVMC for consideration of venoarterialextracorporeal membrane oxygenation (VA-ECMO). Since he was hyperdynamic on echocardiogram, our team did not feel he would benefit from VA-ECMO. •His vasopressor …

When Two Isn’T Better Than One: A Case Of Severe Hyponatremia From Combination Thiazide Diuretic And Arb Therapy, Jillian Catral, Emily Hitchcock

Providence St. Vincent Internal Medicine 2021

Introduction

Thiazide diuretics and angiotensin II receptor blockers (ARB) are common medications for hypertension and are widely used together to counteract thiazide-induced hypokalemia •Thiazide-associated hyponatremia (TAH) is fairly common. There are also multiple case series in the literature of severe hyponatremia in elderly pts attributed to initiation of a thiazide-ARB combination, even when the thiazide dose was low. This is a unique case of hyponatremia in which ARB on thiazide therapy seems to have precipitated severe hyponatremia.

Case Report This is a 74-year-old female with a history of essential hypertension with intolerance to several antihypertensive medications, post-operative hyponatremia after laminectomy …

A Dramatic Presentation Of Plasmablasticlymphoma In Untreated Hiv, Joshua Genstler, Alex Schafir

Providence St. Vincent Internal Medicine 2021

No abstract provided.

When Your Patient Does Know Best: A Lesson In Geriatrics, Daphne Sy, Jeff Youker

Providence St. Vincent Internal Medicine 2021

Introduction

An athletic elderly woman presented to the emergency department (ED) with subjective leg weakness, most notably while climbing stairs. The patient’s insistence that we acknowledge her change in functional status prompted a workup that exposed an active pauci-immune crescentic glomerulonephritis. She was diagnosed with an unusual presentation of granulomatosis with polyangiitis (GPA) which was discovered in time to initiate treatment and prevent renal failure.

Case Report

A 77 year-old woman with a past medical history of chronic kidney disease (CKD) and biopsy-negative pulmonary nodules presented to the ED with a unique complaint: she could no longer climb multiple stairs …

Avoiding Rash Decisions: A Guide To Adverse Cutaneous Drug Reactions, Caleb Freeman, Tom Chau

Providence St. Vincent Internal Medicine 2021

No abstract provided.

A Case Of Succinylcholine-Induced Postoperative Myalgia, Nancy Ha, Stephanie Griffith

Providence St. Vincent Internal Medicine 2021

Introduction

Succinylcholine is a commonly used depolarizing neuromuscular blocking agent in anesthesia for relaxation of the skeletal muscles during endotracheal intubation. It is ideal for use in shorter surgical cases and situations where a rapid sequence intubation is warranted due to its quick onset and short duration of action. One documented side effects of succinylcholine is postoperative myalgia, which was first described in the literature in 1952.

Case Report

An 88 y.o. male presented two days following transurethral resection of a bladder mass with complaints of diffuse myalgias that were severely limiting activity. The pain was greatly exacerbated by any …