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Articles 31 - 60 of 98
Full-Text Articles in Medical Education
Gent-Le Dosing: Evaluating The Safety Of Gentamicin At Higher Doses For Late Preterm And Term Neonates, Jason Hector, D. Erin Wilson, Aiyana Ooki-Knutson, Jennifer Conley
Gent-Le Dosing: Evaluating The Safety Of Gentamicin At Higher Doses For Late Preterm And Term Neonates, Jason Hector, D. Erin Wilson, Aiyana Ooki-Knutson, Jennifer Conley
Books, Presentations, Posters, Etc.
Abstract: In June 2024, Providence St Joseph Health updated the standard gentamicin dose in the Pediatric and Neonatal Aminoglycoside protocol from 4 mg/kg to 5 mg/kg every 24 hours for late preterm and term neonates. This project aims to evaluate late preterm and term neonatal patients who received gentamicin for empiric sepsis coverage within the first seven days of life, at 4 mg/kg/dose or 5 mg/kg/dose, to assess the safety of the standardized 5 mg/kg dosing for late preterm and term neonates after the protocol change. This study is a multicenter retrospective pre-/post-intervention analysis at a multistate health system spanning …
Looking Past The Portal: A Hidden Origin Of Ascites, Paige Ruh, Do, Claudia Leonard, Md
Looking Past The Portal: A Hidden Origin Of Ascites, Paige Ruh, Do, Claudia Leonard, Md
Books, Presentations, Posters, Etc.
Introduction: The most common cause of ascites is portal hypertension secondary to cirrhosis and accounts for nearly 75% of cases. In contrast, pancreatic ascites is a rare presentation of ascites and occurs in less than 1% of patients. Because of its low prevalence, pancreatic ascites is often excluded from the initial differential diagnosis and rarely assessed in ascitic fluid analysis. This is a case in which pancreatic ascites was considered and ultimately confirmed based on the overall clinical picture, challenging the initial assumption of portal hypertension and cirrhosis. Case Presentation: A 47-year-old man with ongoing alcohol use disorder presented to …
Evaluating The Interrater Reliability For The Intern Selection Process Done At Providence Medical Group Psychology Training Program, Vanoosheh Ferdousian, M.A., Teresa Davigo, Luke Dowling
Evaluating The Interrater Reliability For The Intern Selection Process Done At Providence Medical Group Psychology Training Program, Vanoosheh Ferdousian, M.A., Teresa Davigo, Luke Dowling
Books, Presentations, Posters, Etc.
Interrater reliability (IRR) is an important component of evaluation processes that involve subjective judgments, as it reflects the degree of consistency among multiple raters. In training and hiring contexts, establishing adequate IRR helps ensure that applicant evaluations are fair, systematic, and minimally influenced by individual bias. The present program evaluation examines the interrater reliability of the intern selection process at the Providence Medical Group Psychology Training Program. Specifically, this project evaluates the consistency of raters’ scores assigned to internship applicants using the program’s standardized application rating forms. Numerical ratings from multiple reviewers were collected for each applicant and analyzed using …
Beyond The Negative Serologies: A Case Of Fulminant Vasculitis, Multiorgan Dysfunction, And An Uncharacteristic Infection, Guo Hui (Greyson) Gan, Do
Beyond The Negative Serologies: A Case Of Fulminant Vasculitis, Multiorgan Dysfunction, And An Uncharacteristic Infection, Guo Hui (Greyson) Gan, Do
Books, Presentations, Posters, Etc.
Case Presentation: 70-year-old male presented with one week of fever and a painful right lower extremity purpuric rash that rapidly evolved into fullthickness desquamation and necrosis. Concurrent multiorgan dysfunction: respiratory failure, renal failure with nephritic proteinuria, and severe thrombocytopenia refractory to high dose steroids. Extensive serologic workup for viral, autoimmune, vascular, and hematologic etiologies were pan-negative, including serum cryoglobulins twice repeated (QR code for table of workup). A PET scan for a broad evaluation found a hypermetabolic right inguinal lymph node. Discussion: Unique features of this case: His hematologic workup was convincingly negative in setting of having type 1 CryoGN. …
Enhancing Gestational Diabetes Screening, Sataj Johnson, Daniel Ruegg
Enhancing Gestational Diabetes Screening, Sataj Johnson, Daniel Ruegg
Books, Presentations, Posters, Etc.
Background: Gestational diabetes mellitus (GDM) screening is recommended between 24–28 weeks of gestation to allow timely diagnosis and treatment and reduce adverse maternal and neonatal outcomes. The two-step glucose tolerance testing method is supported by ACOG, though completion can be delayed due to the need for multiple tests. In 2024 at Providence Milwaukie Family Medicine Clinic, incomplete GDM screening occurred in 23.1% of patients, and incomplete two-step screening occurred in 33.3%, with an average completion time of 12 days. Objective: To increase completion rates of two-step GDM screening and reduce time between abnormal 1-hour and diagnostic 3-hour glucose tolerance tests …
Acquired Amegakaryocytic Thrombocytopenia And Pure Red Cell Aplasia As Initial Presentation Of Thymoma, Nidhi Patel, Md, Natasha Edwin, Md
Acquired Amegakaryocytic Thrombocytopenia And Pure Red Cell Aplasia As Initial Presentation Of Thymoma, Nidhi Patel, Md, Natasha Edwin, Md
Books, Presentations, Posters, Etc.
Introduction: Pure Red Cell Aplasia (PRCA) is a common feature of thymomas, but it rarely presents with acquired amegakaryocytic thrombocytopenia (AAMT). Here, we present a case of a 59-year-old male with fatigue found to have severe anemia and thrombocytopenia, who was eventually diagnosed with a thymoma Case Presentation: Found to have Hg of 6.1 g/dL and platelet count of 33 k/uL; Reticulocyte count was 0.0068. CT chest showed an anterior mediastinal mass measuring 4.5 x 6.6 cm. Mass biopsy showed thymoma. Bone marrow biopsy showed 50% cellularity with absence of erythroid and megakaryocyte precursors compatible with AAMT and PRCA. At …
Addition Of Gitr Agonist To A Dark Matter Cancer Vaccine And Anti-Pd-1 Increases Regulatory T Cell Numbers Without Appearing To Impact Therapeutic Efficacy, Rom S. Leidner1, Guo Hui Gan1, Christopher C. Paustian, Shawn M. Jensen
Addition Of Gitr Agonist To A Dark Matter Cancer Vaccine And Anti-Pd-1 Increases Regulatory T Cell Numbers Without Appearing To Impact Therapeutic Efficacy, Rom S. Leidner1, Guo Hui Gan1, Christopher C. Paustian, Shawn M. Jensen
Books, Presentations, Posters, Etc.
Background: DPV-001 is an off-the-shelf cancer vaccine containing tumor associated proteins commonly overexpressed in adenocarcinoma and squamous cell carcinoma. It is enriched for short-lived proteins (SLiPs) and defective ribosomal products (DRiPs), including both canonical and non-canonical (or “dark matter”) antigens —comprising over 100 identified non-canonical microproteins. These antigens are delivered in spectrin-coated microvesicles that contain 5 TLR/ NOD agonists and 15DAMPs/molecular chaperones, and target CLEC9A+ conventional dendritic cells (cDCs). Preclinical models showed enhanced antitumor responses when the murine analog of DPV-001 (DRibbles) was combined with co -stimulatory agonists. Additional studies showed enhanced antitumor responses when co-stimulatory agonists were combined with …
Acute Pancreatitis Outcomes In Native Americans In Northern Arizona, Jin Yun Do1, Afsheen Moshtaghi Do2, Hamza Khan, Md2, Hady Shahbaz Bs2, Yoshinobu Koguchi, Tarsem L. Moudgil, Noah D. Simons, Venkatesh Rajamanickam
Acute Pancreatitis Outcomes In Native Americans In Northern Arizona, Jin Yun Do1, Afsheen Moshtaghi Do2, Hamza Khan, Md2, Hady Shahbaz Bs2, Yoshinobu Koguchi, Tarsem L. Moudgil, Noah D. Simons, Venkatesh Rajamanickam
Books, Presentations, Posters, Etc.
Background and Aims: Prior studies have shown the impact of racial and ethnic disparities in outcomes of acute pancreatitis (AP). Data remains sparse for Native American populations, who may be uniquely affected by socioeconomic and geographic factors. This retrospective study aimed to evaluate the disproportionate outcomes of AP in Native Americans compared to the general population in Northern Arizona. Methods: A retrospective cohort study of hospitalized patients with AP at two community hospitals in Northern Arizona. A total of 1,113 patients between Jan and Aug 2024 were included, comprising 413 Native American patients and 700 patients of other racial backgrounds. …
Ceftriaxone-Induced Thrombocytopenia: An Atypical Presentation Of A Commonly Used Antibiotic, Matthew Moritz, Omar Pandhair
Ceftriaxone-Induced Thrombocytopenia: An Atypical Presentation Of A Commonly Used Antibiotic, Matthew Moritz, Omar Pandhair
Books, Presentations, Posters, Etc.
INTRODUCTION: Drug-induced thrombocytopenia (DITP) is rare and impacts roughly ten persons per million people annually (1). Over one-hundred medications have been identified as possible offenders, with immune response occurring within one to two weeks of drug exposure (2). Here we present a case of ceftriaxone as cause of DITP, an extremely rare complication of a commonly used antibiotic. CASE PRESENTATION: A fifty-year-old male with diabetes and depression initially presented after attempted suicide by hanging. He was intubated in the field and admitted directly to the intensive care unit (ICU). He remained in the ICU due to persistent encephalopathy which was …
Supplement Risk, Allison Connor, Bs, Linh Tang Taylor, Md, Jeffrey Youker, Md
Supplement Risk, Allison Connor, Bs, Linh Tang Taylor, Md, Jeffrey Youker, Md
Books, Presentations, Posters, Etc.
Introduction: Increasingly, it is the case that patients are using a variety of supplements. About half of American adults use supplements. ¹. The purpose of this case report is to consider the impact of surreptitious supplement use on clinical presentation and under score the value in gathering a robust patient history. Case report: A 58-year-old man with prior history of infective endocarditis (IE) resulting in bioprosthetic aortic valve replacement (2 years prior) presented with worsening left lumbar pain and low-grade fever. He was found to have Methicillin resistant Staphylococcus aureus bacteremia with L4/5 vertebral osteomyelitis and a left psoas abscess. …
Visual Cues And Pharmacy Pathways Improve Hypertension Management In A Resident Clinic, Gage Lemunyan M.D., Cody Paiva, Do, Mari Kai, Md
Visual Cues And Pharmacy Pathways Improve Hypertension Management In A Resident Clinic, Gage Lemunyan M.D., Cody Paiva, Do, Mari Kai, Md
Books, Presentations, Posters, Etc.
Background: Managing hypertension in ambulatory settings is becoming increasingly challenging, often competing with other visit priorities. “White coat hypertension” remains a key consideration when considering initiating or increasing anti-hypertensives. Blood pressure may be transiently elevated on initial screening and improve on recheck. Problem: In our clinic, only ~55% of patients were at goal, defined as BP < 140/90 at last office visit. • < 50% of patients received serial recheck after identifying an elevated reading. • 43% of same-day rechecks were < 140/90. Aim: Enhance hypertension management using low-cost, easy to implement interventions. Results: Process was examined iteratively, starting with a yellow card that was placed on the door to alert clinicians to the need to recheck blood pressure before discharge. This was continually refined based on staff feedback. Visual cues prompted more frequent rechecks by rooming staff, increasing the rate of those with elevated initial reading who had serial recheck from 48% to 69%, a net increase of 21%. Improvement was seen in clinic-wide blood pressure control, with the percentage of patients with a blood pressure < 140/90 at most recent office visit increasing from 55.7% to 66.6% after 1 year. This represented a net increase of 10.9%. Discussion: Visual cues in the exam room were effective at alerting clinicians for the need for serial BP recheck. These were most-effective when they were “eye catching”. PharmD visits were effective at creating a visit to focus solely on hypertension management, thereby eliminating competing interests that may dominate office visits with their primary care provider. These paired interventions were surprisingly effective at halting clinical inertia and ultimately led to more effective management of hypertension clinic-wide. Team-based EMR messaging was particularly helpful as an adjunct for coordinating timing of blood pressure rechecks. In a residency setting, this can be performed while ‘staffing’ with a faculty physician. Limitations: Current guidelines identify blood pressures >130/80 as hypertensive. This study utilizes 140/90 as a cutoff. Frequency of blood pressure rechecks highly variable based on available support staff. May place strain on support staff when short staffed. PharmD involvement may not be available in every setting
Improving Cervical Cancer Screening At Pmg Southeast Family Medicine Through Implementing A New Screening Tool: Patient-Collected High-Risk Hpv Screening, Brianna Pickering, August Stuppy, Eric Waelbroeck, Ben Pederson, Daniel Ruegg
Improving Cervical Cancer Screening At Pmg Southeast Family Medicine Through Implementing A New Screening Tool: Patient-Collected High-Risk Hpv Screening, Brianna Pickering, August Stuppy, Eric Waelbroeck, Ben Pederson, Daniel Ruegg
Books, Presentations, Posters, Etc.
No abstract provided.
When Jaundice Isn’T Just The Liver’S Fault: A Chilly Case Of Cold Autoimmune Hemolytic Anemia, Jennifer Wong, Do, Shahana Baig-Lewis, Md, Mph
When Jaundice Isn’T Just The Liver’S Fault: A Chilly Case Of Cold Autoimmune Hemolytic Anemia, Jennifer Wong, Do, Shahana Baig-Lewis, Md, Mph
Books, Presentations, Posters, Etc.
Introduction: Cold agglutinin disease (CAD), a subtype of autoimmune hemolytic anemia (AIHA), is characterized by IgM autoantibodies that target red blood cell antigens at low temperatures, leading to agglutination in cooler peripheral tissues and hemolysis. Predominately directed against the “I” or “i” antigens, cold agglutinins are commonly associated with Mycoplasma pneumoniae and infectious mononucleosis. Distinguishing warm AIHA from CAD can be challenging. Definitive diagnosis relies on antibody testing, with warm AIHA primarily involving IgG and CAD involving IgM. We report a case of CAD initially misattributed to drug-induced liver injury in the setting of a viral upper respiratory infection. Case …
An Atypical Presentation Of Metastatic Gastric Adenocarcinoma Due To Pulmonary Lymphangitic Carcinomatosis, Matthew Moritz, Omar Pandhair
An Atypical Presentation Of Metastatic Gastric Adenocarcinoma Due To Pulmonary Lymphangitic Carcinomatosis, Matthew Moritz, Omar Pandhair
Books, Presentations, Posters, Etc.
Pulmonary lymphangitic carcinomatosis (PLC) accounts for approximately 8% of pulmonary metastases and is primarily associated with breast, lung, and gastric cancers. Chest radiographs are often nonspecific and normal in approximately 50% of cases. We present a case of PLC as an initial presentation of metastatic gastric adenocarcinoma. A 57-year-old White woman with prior tobacco use, asthma, and multiple sclerosis on Natalizumab presented with three months of progressive dyspnea and cough. She was evaluated multiple times and treated with various antibiotics and inhalers for presumed bronchitis. Despite this, her symptoms worsened, prompting hospital evaluation. She was tachycardic and markedly hypoxemic on …
An Exploration Of Drivers Of Sepsis Outcomes In Racial And Ethnic Minority Populations, Matthew Moritz, Omar Pandhair, Shelley Schoepflin Sanders
An Exploration Of Drivers Of Sepsis Outcomes In Racial And Ethnic Minority Populations, Matthew Moritz, Omar Pandhair, Shelley Schoepflin Sanders
Books, Presentations, Posters, Etc.
RATIONALE: Race and ethnicity affect sepsis outcomes in unclear ways. Existing data is conflicting, with some studies suggesting minority patients do worse, while others did not show a difference in outcomes between these groups. We sought to investigate whether inequalities exist in sepsis outcomes for different racial and ethnic groups in our large hospital system and to characterize how they may manifest. METHODS: We performed a retrospective cohort study of adults diagnosed with sepsis and discharged from any of Providence’s 52 hospitals between January 1 and December 31, 2023. We grouped patients into ten different race/ethnicity groups including White, Black, …
A Case Of Sweet Syndrome In A Patient With Myelodysplastic Syndrome, Malia’Ka Hall, Do, Elizabeth Hutshinson, Md
A Case Of Sweet Syndrome In A Patient With Myelodysplastic Syndrome, Malia’Ka Hall, Do, Elizabeth Hutshinson, Md
Books, Presentations, Posters, Etc.
Introduction: Sweet syndrome, also known as acute febrile neutrophilic dermatosis, is a rare inflammatory disorder characterized by the abrupt onset of high fevers and exquisitely tender, erythematous skin lesions that may appear on virtually any area of the body. These lesions typically manifest as papules, nodules, or plaques and often evolve rapidly, contributing to the dramatic clinical presentation. Although uncommon—with only several hundred cases documented in the literature—Sweet syndrome remains an important diagnostic consideration due to its distinctive combination of cutaneous findings and systemic symptoms, as well as its potential association with underlying malignancy, infection, or medication exposure. Presentation: A …
Individuals Deemed Low Risk For Cardiotoxicity With Her2-Directed Antibody Therapy Developed Modest Incidences Of Treatment-Related Lvef Decline And Heart Failure Across A Large Western Us Hospital System, Cameron Smith1, David Page1, Michael Layoun, Li Hsin-Fang
Individuals Deemed Low Risk For Cardiotoxicity With Her2-Directed Antibody Therapy Developed Modest Incidences Of Treatment-Related Lvef Decline And Heart Failure Across A Large Western Us Hospital System, Cameron Smith1, David Page1, Michael Layoun, Li Hsin-Fang
Books, Presentations, Posters, Etc.
Background: Incidence of anti-HER2 cardiotoxicity varies widely from 3-30%. Baseline cardiac risk factors can drastically affect an individual's risk of cardiotoxicity while on anti-HER2 therapies. Risk stratification calculators like the HFA-ICOS tool can estimate relative risk of cardiotoxicity based on preceding risk factors. High risk factors: Heart failure (HF), CAD, severe valvular heart disease. Mild-moderate risk factors: HTN, DM, CKD, age 65-79, anthracycline use, arrhythmia, smoking history, BMI>30. De-intensified surveillance has been proposed for low-risk patients. Objective: Characterize incidence and predictors of cardiotoxicity in a real world population of early-stage breast cancer patients receiving anti-HER2 therapies. Evaluate incidence of …
Postpartum Spontaneous Coronary Artery Dissection With Multivessel Arteriopathy, Devon Schaefer, Do, Cody Paiva, Do
Postpartum Spontaneous Coronary Artery Dissection With Multivessel Arteriopathy, Devon Schaefer, Do, Cody Paiva, Do
Books, Presentations, Posters, Etc.
Case Presentation: Hospital Day 0 – Presentation: 43-year-old postpartum female (s/p C-section 4-months prior) presenting with recurrent central chest pressure after several days of intermittent symptoms. She was hemodynamically stable but had diffuse T‑wave inversions and a marked troponin rise. Treated with aspirin, nitroglycerin, and heparin for presumed NSTEMI. Coronary angiography planned. Hospital Day 1 -- Initial Angiography: TTE showed mildly reduced EF with apical akinesis. Angiogram read as mild diffuse mid-distal LAD disease (Figure 1), but no evidence of obstructive disease or culprit lesion. Working diagnosis was MINOCA, stress cardiomyopathy, or an occult SCAD. Hospital Day 2 -- Diagnostic …
Revolutionizing Hematology/Oncology Education With Visual Storytelling And “Gamification” For Internal Medicine Residents, N Smith1, A Patel1, J Dechet, C Powell
Revolutionizing Hematology/Oncology Education With Visual Storytelling And “Gamification” For Internal Medicine Residents, N Smith1, A Patel1, J Dechet, C Powell
Books, Presentations, Posters, Etc.
Introduction: Hematology/oncology ranks among the lowest scoring sections on in-training exams for internal medicine residents. Prior resident feedback expressed a need for an improved didactic curriculum that was applicable to internal medicine residents and board examinations Aim: To enhance curriculum through multimodal education by integrating traditional didactic presentations along with specific lectures utilizing visual storytelling, memory palaces, and gamification. Methods: Trainees completed a 5-point Likert scale survey on their perceptions of hematology and oncology with a 16-question quiz before and after the curriculum. Multimodal lecture series created using "murder mystery" and "jewel heist" to teach hemolytic anemia, team-based Jeopardy-style format …
Breakthroughs In Cervical Cancer Screening: Hpv Self-Collection At Pmg Milwaukie Family Medicine Clinic, Brandon Bartlett, Sataj Johnson, Emily Miyasako, Rachel Gallagher, Daniel Ruegg
Breakthroughs In Cervical Cancer Screening: Hpv Self-Collection At Pmg Milwaukie Family Medicine Clinic, Brandon Bartlett, Sataj Johnson, Emily Miyasako, Rachel Gallagher, Daniel Ruegg
Books, Presentations, Posters, Etc.
Background: Cervical cancer screening is a cornerstone of preventative healthcare and cancer screening in primary care. Based on data from the CDC, in the US alone, the rate of new cervical cancers each year is ~13,000, accounts for ~4,000 deaths annually, and disproportionally effects people of color and people of low SES (CDC, 2025). In our clinic (PMG Milwaukie), the rate of cervical cancer screening has remained around 70% for years, which is below the national average of ~75% (Healthy People, 2021). Primary HPV screening with self-collected swabs has been used successfully for years outside of the US, improving screening …
Improving Post-Hospital Medication Reconciliation In A Rural Primary Care Clinic Through An Rn-Led Workflow, Jack Kennady
Improving Post-Hospital Medication Reconciliation In A Rural Primary Care Clinic Through An Rn-Led Workflow, Jack Kennady
Books, Presentations, Posters, Etc.
Context/background: Adverse events after hospital discharge are common and represent a major patient safety concern. Approximately 1 in 5 patients experience a safety event after discharge, and 39% of these events are adverse drug events (ADEs), with 26% considered preventable. Medication discrepancies during transitions of care contribute significantly to these events, with an estimated 40% of medication errors resulting from inadequate medication reconciliation. Rural primary care clinics face additional challenges, including limited communication between inpatient and outpatient systems and inconsistent reconciliation workflows. Improving medication reconciliation during the transition from hospital discharge to outpatient follow-up represents an important opportunity for family …
Improving Recognition Of Chronic Kidney Disease In A Federally Qualified Health Center Through A Quality Improvement Initiative, Rachel Monroe, Evan Saulino, Kathleen Mckenna
Improving Recognition Of Chronic Kidney Disease In A Federally Qualified Health Center Through A Quality Improvement Initiative, Rachel Monroe, Evan Saulino, Kathleen Mckenna
Books, Presentations, Posters, Etc.
Context/background: Chronic kidney disease (CKD) affects approximately 15% of adults in the United States, yet nearly 90% of affected individuals are unaware of their diagnosis. Early identification in primary care enables interventions such as blood pressure optimization, renin –angiotensin system blockade, and kidney -protective medications that can significantly delay disease progression and postpone dialysis. Screening and diagnosis gaps disproportionately affect high -risk populations, including Latinx patients and immigrant agricultural workers commonly served in federally qualified health centers (FQHCs). National CKD screening rates among patients with diabetes or hypertension remain low, leaving many high -risk individuals unscreened for kidney disease. Improving …
Increasing Structured Inpatient Teaching In A Family Medicine Residency, Eric Waelbroeck, Mh Choe
Increasing Structured Inpatient Teaching In A Family Medicine Residency, Eric Waelbroeck, Mh Choe
Books, Presentations, Posters, Etc.
Background: What is not measured cannot be improved. Residents at Providence Milwaukie Family Medicine Residency identified a need to increase structured teaching on inpatient rotations. Other projects aimed at increasing structured teaching during family medicine training have demonstrated improvements in resident confidence in key areas of practice, licensing exam performance, and resident satisfaction with their training. However, without a system of measurement, the number of teaching opportunities cannot be reliably improved. Objectives: Develop a method of documenting structured inpatient teaching that occurs at Providence Milwaukie Hospital. Then, implement interventions using a quality improvement model to increase structured teaching over time. …
A Vexing Case: A Newly Discovered Autoinflammatory Disease, Ashley Edwards, Md, Caroline Mcculley
A Vexing Case: A Newly Discovered Autoinflammatory Disease, Ashley Edwards, Md, Caroline Mcculley
Books, Presentations, Posters, Etc.
Introduction: Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) Syndrome is a recently recognized adult-onset autoinflammatory disease that can lead to potentially lifethreatening multi-system inflammation with estimated prevalence of up to 1 in 5,000 males over the age of 50. Given its significant morbidity and mortality and high prevalence, increased awareness of this condition is of foremost importance. Herein we outline a case of VEXAS syndrome. Case Presentation: Mr. N is a 73-year-old male with a past medical history significant for hypertension and recent episode of uveitis who first presented to the hospital for significant unintentional weight loss, fevers, and abdominal …
Characterization Of Sarcoidosis At A Combined Rheumatology-Pulmonary Clinic, Megan Schermerhorn, Md, Julianna Desmarais, Md
Characterization Of Sarcoidosis At A Combined Rheumatology-Pulmonary Clinic, Megan Schermerhorn, Md, Julianna Desmarais, Md
Books, Presentations, Posters, Etc.
Introduction: Sarcoidosis is a disease of unknown etiology characterized by formation of small clusters of inflammatory cells that form granulomas. Heterogenous and typically involves multiple organ systems with varying degrees of morbidity and mortality. Poorly defined treatment landscape. The purpose of this study was to characterize a cohort of sarcoidosis patients in a combined rheumatology-pulmonary clinic according to organ involvement and treatment over 5 years. Discussion: •Single center academic study of a that is the first of its kind. •Data highlights complexity and heterogeneity of patients with sarcoidosis and utility of combined rheumatology – pulmonary clinic. •65.3% of patients exhibited …
A Diagnostic Challenge—Tinu Syndrome, Sophia Lee, Md, Claire Kassakian, Md
A Diagnostic Challenge—Tinu Syndrome, Sophia Lee, Md, Claire Kassakian, Md
Books, Presentations, Posters, Etc.
Introduction: •TINU Syndrome: Tubulointerstitial Nephritis and Uveitis rare multi-system syndrome has renal manifestations typical of acute interstitial nephritis (AIN), in addition to bilateral anterior uveitis not well-understood •Thought to be an immune-mediated process, although mechanisms for disease remain unclear Likely secondary to a combination of genetic predisposition and certain environmental exposures •Genetic predisposition: specific HLA phenotypes possibly an auto-antigen to modified C-reactive protein (mCRP) •Potential triggers: Infections: tuberculosis, EBV, varicella zoster, chlamydia, toxoplasma Medications: antibiotics (β-lactams, meropenem, azithromycin, levofloxacin), NSAIDs, goreisan (Chinese herb) Endocrine diseases: hypoparathyroidism, hyperparathyroidism, rheumatoid arthritis, IgG4-related autoimmune …
Case Study: A Severe Presentation Of Chronic Eosinophilic Pneumonia., Revati Kalluri, Mari Kai
Case Study: A Severe Presentation Of Chronic Eosinophilic Pneumonia., Revati Kalluri, Mari Kai
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Case Presentation: Chief Complaint •55-year-old male with history of COPD, current 1 pack/day smoker, and 2-month history of hypoxic respiratory failure presents with increased shortness of breath. History of Present Illness •Initially hospitalized for a motor vehicle collision with course complicated by acute hypoxic respiratory failure due to eosinophilic pneumonia and treated with a 14-day prednisone taper. •Few days after discharge, he represented with acute hypoxic respiratory failure thought to be from a COPD exacerbation and treated with a short steroid taper. •Now, represents few days later with continued tachypnea, tachycardia, hypotension, and hypoxia.. Discussion: •Broad Differential including Pneumonia, Fat …
From Dormant To Dangerous: Hepatitis B Reactivation Under Immunosuppression, Adam Knott, Md, Amy Dechet
From Dormant To Dangerous: Hepatitis B Reactivation Under Immunosuppression, Adam Knott, Md, Amy Dechet
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Introduction: •HBV reactivation is a known phenomenon affecting those with prior HBV infection. In rare cases, this occurs spontaneously, but most often reactivation will occur while the host is immunocompromised. •Hepatitis B Virus (HBV) remains in the nucleus of hepatocytes and cannot be fully eradicated. •The following case highlights important considerations regarding HBV. Case Presentation: •A 78 y.o. male presented with emesis and progressive painless jaundice. •Prior history of treated HCV, Hepatocellular Carcinoma, HBV vaccination, and autoimmune Interstitial Lung Disease on Mycophenolate. •No recent risk factors, such as alcohol use, IV drug use, or sexual activity. •Previous tests for Hepatitis …
Immune Checkpoint Inhibitors: Friend Or Foe, Antonio Cordova, Jesse Powell, Whitney Elg-Salsman, Caroline Mcculley
Immune Checkpoint Inhibitors: Friend Or Foe, Antonio Cordova, Jesse Powell, Whitney Elg-Salsman, Caroline Mcculley
Books, Presentations, Posters, Etc.
Introduction: • Many cancers use mechanisms to escape killing by the immunesystem. • Cancer cells can mimicimmune checkpoint proteins such as cytotoxic T lymphocyte–associated antigen 4 (CTLA-4) ligand and the programmed death1 receptor ligand (PD-L1) toinhibit the T-cell response. • Immune checkpoint inhibitors (ICI's) are a novel set of monoclonalantibody cancer therapies. • ICI'sblockcheckpoint proteins from binding with their partner proteins oncancer cells thus allowing T-cells to kill tumor cells. • ICIs have promising anti-cancer results. • ICIs are also associated with immune related adverse events(irAEs), including dermatitis, pneumonitis, colitis,hepatitis, nephritis. • A rare but seriousirAEisICI-associated myositis causing bulbar and …
Unveiling The Mystery: Paraneoplastic Syndrome Masquerading As Skin Thickening, Megan Schermerhorn, Md, Quian Leng, Atish Dey
Unveiling The Mystery: Paraneoplastic Syndrome Masquerading As Skin Thickening, Megan Schermerhorn, Md, Quian Leng, Atish Dey
Books, Presentations, Posters, Etc.
Introduction: Systemic sclerosis is a rare autoimmune disorder defined by skin thickening in the distal digits and is frequently accompanied by inflammatory arthritis. There are known mimics of systemic sclerosis, which present with similar sclerosis of the skin. Palmar fasciitis and polyarthritis syndrome (PFPAS) is a rare paraneoplastic syndrome that presents with progressive flexion contractures of the hands, inflammatory fasciitis, fibrosis, and generalized inflammatory arthritis. PFPAS is most associated with ovarian adenocarcinoma, and rarely associated with pancreatic adenocarcinoma. Early recognition of this rare syndrome was critical in identifying an asymptomatic pancreatic adenocarcinoma. Case Description: 58-year-old woman with osteoarthritis of multiple …