Medical Specialties Commons^™

A Case Of Medication-Induced Diffuse Alveolar Hemorrhage In Neurofibromatosis Type 1, Ashar Mahmood, Liz Palmer, Rebecca Schuyler, Svitlana Sharpovalova, Bilal Nadeem, Mukesh Mehta, Salman Muddassir, Nikolay Mitzov, Monicka S. Felix

West Florida Division GME Research Day 2020

• Amiodarone, an antiarrhythmic and apixaban, an anticoagulant have been associated with diffuse alveolar hemorrhage (DAH).
• Cases have been documented demonstrating DAH in the setting of amiodarone and apixabantreatment, however there are few cases examining DAH in combination therapy.
• We present a case of diffuse alveolar hemorrhage in the setting of amiodarone and apixaban treatment for paroxysmal atrial fibrillation.
• NF1 is know to have higher risk for major bleeds due to their friable vasculature.

Diaphragmatic Paralysis: A Presentation Of Spontaneous Chest Pain And Shortness Of Breath, Donna Dorriz, Hilary Lois, Candace Wise, Brady Dehart

Capital Division GME Virtual Research Day 2020

Chest pain accounts for approximately 7.6 million annual visits to emergency departments (ED) in the United States and can include a broad differential1. The workup warranted includes extensive testing with the goal of demonstrating a reassuring cardiopulmonary status. When preliminary chest pain workup is negative, the subtle features of common primary symptoms can provide insight into other less common etiologies. This case looks to highlight the rare presentation of a relatively healthy middle age male with complaint of chest pain and shortness of breath, worsened with exertion and supine position. When standard cardiopulmonary workup was negative, further specialty testing was …

A Rare Cause Of Pneumoperitoneum, Robert Zusman, George Michael, Anna E. Augustin, My Myers, Dudith Pierre-Victor

West Florida Division GME Research Day 2020

Pneumoperitoneum is most commonly associated with a perforated viscus. When free air is seen on imaging, the most common course of action is an emergent exploratory laparotomy. However, pneumoperitoneum may not always be indicative of a perforated bowel. In the case described below, we will discuss a patient who developed acute peritonitis and pneumoperitoneum after undergoing chest compressions during cardiopulmonary resuscitation (CPR) and positive pressure mechanical ventilation.

The Spectrum Of Large Adrenal Masses: A Case Series, Jo Cooke-Barber, Sarah E. Hatef, Analise Mcgreal, Andrew Schwemmer, Christopher Senkowski

HCA Healthcare Journal of Medicine

Background: Adrenocortical carcinoma (ACC) is a rare malignancy that is challenging to diagnose and has important implications for surgeons who approach this disease. Despite its rarity, it must always be in the differential diagnosis when investigating and treating large adrenal masses. We aim to demonstrate the complexities of this disease through a review of five recent patients at a single tertiary care center.

Methods: A series of five patients are described, each of whom presented to a single institution as referrals for "large adrenal mass" in the past sixteen months. Their pre-operative diagnosis, radiographic findings, the operative approach and the …

Acute Disseminated Encephalomyelitis, Ashan Hatharasinghe, Hossein Akhondi, Don Pepito

HCA Healthcare Journal of Medicine

Introduction: Acute Disseminated Encephalomyelitis (ADEM) is a rare autoimmune demyelinating disorder of the central nervous system. Clinical manifestations include encephalopathy, motor deficits, ataxia, and meningeal signs. In most cases, ADEM is preceded by either vaccination or viral illness. Here, we present a case with neither of the two predisposing elements.

Discussion: A 28-year-old Hispanic female presenting with substance use and suicidal ideation was placed on an involuntary psychiatric hold, started on olanzapine and scheduled for a psychiatric facility transfer. The following day, she was noted to have neurological deficits when ambulating. Computed tomography of the brain showed a right frontal …

The Use Of Intra-Arterial Vancomycin In Splenic Artery Embolization To Decrease Post-Procedural Infections, Darby Shuler, Jeffrey Bodner, Ricardo Yamada, Marcelo Guimaraes, Heather Collins, Claudio Schonholz, D Thor Johnson, Christopher Hannegan

Radiology

To determine efficacy of vancomycin administration into the splenic artery immediately prior to embolization in decreasing the rate of post-procedural splenic abscess formation.

A Case Of Pacemaker Syndrome Mimicking A Heart Failure Exacerbation, Seline Haci, Som Aftabizadeh, Senthil Thambidorai, Karan Gupta, Ahsan Khan, Aman Patel, Kimberly Wilson, Anand Subramanian

Cardiology

No abstract provided.

Case Series Of Anca Vasculitis As Prognostic Marker For Severity Or Relapse Of Glomerulonephritis., Jake N. Cho, Venkat Chitumalla, Izuchukwu Nwakoby

Nephrology

No abstract provided.

A Case Series Of Hyponatremia And Management In Hospitalized Patients, Jake N. Cho, Rebecca Ong, Izuchukwu Nwakoby

Nephrology

No abstract provided.

Differences In Outcomes Of St-Segment Elevation Myocardial Infarction In African American Women Versus Women From Other Races: A United States National Study., Tasleem Katchi, Sanja Virani, Shaun Smithson, Bryan Curry

Cardiology

No abstract provided.

Two Resident Wellness Exercises And Their Impact, Nick J. Mccauley

Emergency Medicine

How program leaders in the CORD community are implementing innovations to improve residency wellness and resident resilience.

• Define resilience and describe how it can prevent burnout.
• Discuss ways that residency programs can work to promote resilience amongst residents COURSE DESCRIPTIONS #CORDAA20 35
• Introduce ‘Resilience Rounds’ as a didactic intervention, and the literature upon which this innovation is based
• Introduce art as a tool to overcome trauma and prevent burnout
• Demonstrate how conference/didactic time can help residents combat the perceived “culture of perfection” by sharing meaningful or successful moments with each other to improve one’s general outlook on their own practice

Scheduling Like A Pro, Joseph Gibney

Emergency Medicine

Scheduling is difficult, but believe it or not, it can also be rewarding. This is one chief’s take on three years of scheduling and the highs, lows, do’s, don’ts, and novel ways to help your fellow residents live their best residency life.

• Show that resident wellness is impacted by scheduling
• Demonstrate our scheduling process, some errors we made over time, and how we learned from them
• Discuss some novel scheduling tactics, how other residencies may apply what we’ve learned, and how to adapt it to fit their needs

Metastatic Spinal Cord Compression Mimicking Cauda Equina Syndrome Illustrating Importance Of Adequate Diagnostic Imaging, Jonathan L. Holt, Joseph Hill, Farzin Farhandnejad, Karyn Doddy, Se Won Lee

Physical Medicine & Rehabilitation

See additional files.

Rehabilitation Following Valproic Acid-Induced Hyperammonemic Encephalopathy (Vhe) In A Patient With Intractable Epilepsy, Dan Nguyen, Ann Ikonne, Sewon Lee, Mark Steinhauer

Physical Medicine & Rehabilitation

See additional documents.

Worsening Weakness After Posterior Cervical Decompression And Fusion; The Challenge In Diagnosis, Steven D. Kim, Joseph Hill, Farzin Farhandnejad, Karyn Doddy

Physical Medicine & Rehabilitation

See additional files.

Unmasking Severe Hypotension After Intermittent Catheter For Distended Bladder In A Patient With Cervical Spinal Cord Injury, Dennis Nguyen, Neal Ekpoudia, Ellsworth Remson, Farzin Farhandnejad, Se Won Lee

Physical Medicine & Rehabilitation

See additional files.

Concussion, Anthony Shadiack

Sports Medicine

No abstract provided.

Ct Rapid Implementation In A 600+ Bed Hospital Serving 35 Counties In The Southeast, Christopher Burns Do, Adam Kassar Md, Jacob Beltz Md, Klie Hoffa, Peter Britt

Radiology

No abstract provided.

Why I Brought My Mother Home, Barbara L. Gracious

HCA Healthcare Journal of Medicine

According to the Alzheimer’s Association, in the United States more than 16 million adult family members provide care for a relative with Alzheimer’s disease or other dementia. The economic value contributed by unpaid caregivers is $234 billion dollars. Such caregivers are vital to the ability of the U.S. to meet caretaking needs, as the projected number of individuals suffering from dementia will nearly triple over the next 30 years. A meta-analysis found that decisions to provide family caretaking are rooted in long-standing family relationships. This essay explores one family’s decision to move from long-term institutional care back to family-based care …

Assessing For Gender Disparities In The Selection Of Chief Residents Of Emergency Medicine Residency Programs, Emilio G. Volz, Justin Steinberg, Tony Zitek

HCA Healthcare Journal of Medicine

Introduction: Although the number of women physicians has been increasing, there may be gender disparities in the assessment of female emergency medicine residents. This study sought to determine if female emergency medicine residents are less likely to become chief residents than males.

Methods: In July 2017, an anonymous survey was distributed to the program coordinators of all accredited emergency medicine residency programs in the United States. The survey requested the number of males and females in each graduating class from 2015 to 2017. The percentage of female residents who were chief residents was calculated and compared to that for males. …

The Great Imitator Strikes Again: A Case Of A Lupus Flare-Up Presenting Like An Acute Abdomen, Emmanouil Kiriakopoulos, Vanessa Perez, Robyn Hoelle

HCA Healthcare Journal of Medicine

Systemic lupus erythematosus (SLE) is an autoimmune disease affecting all age groups and can manifest in various forms, often making the initial or successive presentations difficult to diagnose. Peritonitis secondary to lupus is a rare manifestation of this disease and the prevalence is said to be much lower in children. We present a case report of an adolescent male with a known history of lupus who presented to the emergency department with a clinical picture consistent with an acute surgical abdomen and underwent an appendectomy. Subsequent workup identified the culprit as a lupus-related peritonitis requiring corticosteroids for resolution.

Periodic Paralysis Syndromes: A T3 Thyrotoxicosis Etiology Presentation And Review Of Literature, Alex Chao, Hossein Akhondi

HCA Healthcare Journal of Medicine

Periodic paralysis is a group of muscle diseases that are related to transmembrane ion channels. Dysfunction of these channels causes an increase in sodium-potassium (Na-K) adenosinetriphosphatase (ATPase) activity that pushes potassium into the cells that result in serum hypokalemia that manifests as muscle weakness. Beta-adrenergic stimulation and insulin sensitivity might also play a role.

Periodic paralysis is divided into hereditary and acquired forms. Thyrotoxic periodic paralysis is an acquired form of periodic paralysis that manifests as muscle weakness, hypokalemia, and hyperthyroidism. The onset of the symptoms is mainly over the age of 20 and can be triggered by intense physical …

A Novel Case Of Bacterial Meningitis In A Patient With Loeys-Dietz, Lacey D. Colvin Do, Christy Fagg

Infectious Disease

No abstract provided.

Diagonal 1 And Mid-Lad Myocardial Bridge With Elevated Troponin Enzymes, Ronak Patel Do

Cardiology

No abstract provided.

A Quality Intervention To Reduce Telemetry, Alina Polonsky Md, Abdullah Alcharif Md, Andrew Maiolo Md

Internal Medicine

No abstract provided.

The Role Of Mindset, Impostorism, And Irrational Beliefs In Resident Wellness: Results From The Hca Nationwide Longitudinal Resident Wellness Study, Gregory Guldner, Jason Siegel, Brendon Ellis, Anne Brafford

Medical Education

Background The significant proportion of residents reporting poor levels of well-being has appropriately fueled a call for interventions. Yet the specific constructs that impact well-being have not been well researched and validated in the resident population. Mindset (fixed versus growth), impostorism (the belief that one’s success is fraudulent) and irrational beliefs (dysfunctional beliefs that contribute to emotional pain and anguish) are among individual variables postulated to relate to well-being in a high-pressure educational environment. Each of these constructs is amenable to interventions should they have causal relationships to well-being.

Objectives Our prior research resulted in a statistically validated model of …

Bullet Hole Sinus Tarsi: Functional And Radiographic Outcomes Following A Self-Inflicted Gunshot Wound To The Talus With Vascular Injury, Eric P. Krznaric Dpm, John R. Greaves Dpm, Jason C. Spector Dpm, Alan A. Macgill Dpm, Christopher Ochner

Podiatry

No abstract provided.

Staged Management Of High-Energy Complex Tibial Pilon Fractures, Gan Golshteyn Dpm, Gina Nguyen Dpm, Bradley Roth Do, Marie Williams Dpm

Podiatry

No abstract provided.

A Unique Schwannoma Of The Distal Hallux: A Case Study, Rebecca D. Stack Dpm, Brett Sachs Dpm Facfas, Dustin Kruse Dpm, Paul A. Stone Dpm, Facfas

Podiatry

No abstract provided.

Isolated Forefoot Juvenile Xanthogranuloma: Unique Case Study And Treatment In A Pediatric Patient, Brian Derner Dpm, Kristine Hoffman, Amy Storfa Md, Dustin Kruse Dpm, Paul A. Stone Dpm, Facfas

Podiatry

Juvenile xanthogranulomas (JXG) are a benign histiocytic cell proliferative disorder in early childhood. They most commonly present within the first two years of life with papular or nodular changes to the skin on the head, neck or upper trunk. Xanthogranulomas are mostly self-limiting, can be singular or multiple, and rarely can infer a systemic disease process1. The purpose of this study was to publish a unique finding of an extra-tendinous solitary mass in an otherwise healthy 17-year old, with surgical and medical treatment after diagnosis.