Internal Medicine Commons^™

A Double-Edged Sword: Accelerated Metastasis After Video-Assisted Thoracoscopic Surgery In Advanced Lung Adenocarcinoma, Grace Anne Martin, Kanwar Bir Dhaliwal, Mala Goyal

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Histotripsy In Liver Tumors: A Non-Thermal, Cavitation Platform Redefining Precision Ablation And Immuno-Oncology Synergy, Subuhee Ahmed, Shahzaib Maqbool, Pradeep Rajbhandari, Mohamad Mahfouz, Maikel Tawadrous

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Post-Vaccination Cardiac Arrhythmias: Phenotype-Specific Severity, Temporal Patterns, And Vaccine-Type Associations In A National Pharmacovigilance Cohort, Prithvi Basu Roy, Syed Ali Abidi, Lawrence San Jose, Louis Orlando

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Bridging Cardiothoracic Care: Using Cardiomemstm To Mitigate Effusion-Driven Respiratory Events In Post-Surgical Heart Failure, Pankti Shah, Kumar Abhishek, Pratyush Kumar, Aradhana Pandey

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Empiric Antibiotic And Corticosteroid Prescribing For Hospitalized Acute Exacerbations Of Copd: Associations With Length Of Stay And Readmissions In A Large Multicenter U.S. Cohort, Kumar Abhishek, Pratyush Kumar, Archana Machavarapu, Munaf Siyamwala, Michael Waxman, Jeffrey Durbin, Kari Nilsen

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Termination Of A Fatal Malignant Arrhythmia By Treating Respiratory Alkalosis At The Ventilator: A Case Report, Thea Danielle Amadasun, Muhammed Salman Ullah, Vladimir Begilman

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Heparin-Induced Thrombocytopenia Among Patients With Acute Pulmonary Embolism And Risk Factors For Mortality, Kawar Bir Dhaliwal, Rahul Pawa, Naresh Kodwani

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Transient Stunning Of Leadless Pacemaker Diagnostic Function Following Pulse Field Ablation For Atrial Arrythmia, Danish Bawa, Stephanie Billingsly, Thomas Pritchard, Rachad Ghazal, Adnan Ahmed, Douglas Darden, Dhanunjaya Lakkireddy

MidAmerica Division GME Healthcare Symposium 2026

No abstract provided.

Bridging The Gap: Early Recognition And Interim Management Of Silica-Associated Rheumatoid Arthritis In Resource-Limited Primary Care Settings, Sukhneet Bhullar, Howard J. Tan, Alaa Baqer, Cathlen Delva

West Florida Division GME Research Day 2026

No abstract provided.

Multifocal Gastrointestinal Diffuse Large B-Cell Lymphoma Initially Resembling Crohn’S Disease, Mary Moussa, Durga A. Kumar, Vikas Sethi, Alvin Boyd Newman-Caro, Christopher Halleman, Michael Schulman

West Florida Division GME Research Day 2026

No abstract provided.

Contemporary Nonfemoral Access For Tavr: Comparative Outcomes Of Transcarotid, Transsubclavian/Transaxillary, And Transcaval Approaches, Yves Najm Mrad, Snehalkumar Patel

Gulf Coast Division GME Research Day 2026

No abstract provided.

Making Loading-Dose Atorvastatin The Default For Patients Presenting With Acs Leads To Increased Administration, Farhan Hiya, Suppraja Soundarrajan, Ali Hassan, Zain Awan, Ahmad Hayat, Andrew Niclosi

West Florida Division GME Research Day 2026

No abstract provided.

Conduction System Pacing Vs Biventricular Pacing: A Meta Analysis Of Randomized Controlled Trials In Cardiac Resynchronization Therapy, Mustafa Tahir, Muhammad Abdullah, Jaafar Hamdan, Michael D. Moore, Nagaraja D. Sharma, Olu Oyesanmi, Salman M. Muddassir

West Florida Division GME Research Day 2026

No abstract provided.

A Rare Case Of Hashimoto Encephalopathy Disguised As Rapidly Progressive Dementia, Sai Santosh Sreenivasan, Kristen Howerton, Monicka S. Felix

West Florida Division GME Research Day 2026

No abstract provided.

Gastrointestinal Ebv In Immunosuppressed Hosts: A Case Of Ptld After Kidney Transplant, Mary Moussa, Baylen Shoemaker, Vikas Sethi, Alvin Boyd Newman-Caro, Rakhee Shah, Patricia Chun, Michael Schulman

West Florida Division GME Research Day 2026

No abstract provided.

Splenic Ectopic Pregnancy: A Rare Cause Of Hemoperitoneum With Diagnostic Challenges-A Case Report And Literature Review, Mustafa Tahir, Nuzhat Shahid, Sainarayana Mangu, Serena Usmani Qureshi, Neami Tervil

West Florida Division GME Research Day 2026

No abstract provided.

Prophylactic Distal Perfusion Catheters In Femoral Va-Ecmo: Association With Lower Limb Ischemia And Major Limb Outcomes (Systematic Review & Meta-Analysis), Yves Najm Mrad, Snehalkumar Patel

Gulf Coast Division GME Research Day 2026

No abstract provided.

Calcinosis Cutis In A Young Patient With End-Stage Renal Disease: A Severe And Morbid Complication, Gopi Mulaka, Babu Shaik, Jaya Surya Manimekalai, Durga Dandu, Rupali Prabhukhot

North Texas GME Research Forum 2026

BACKGROUND/ INTRODUCTION: Calcinosis cutis is a rare but serious complication of end-stage renal disease (ESRD), often related to disordered calcium–phosphate metabolism. It can lead to significant morbidity, recurrent infections, and challenging management decisions.

CASE PRESENTATION: We present a 23-year-old male with ESRD on hemodialysis, hypertension, anemia of chronic disease, and a left upper extremity arteriovenous fistula who developed progressive pain, swelling, and purulent drainage involving the left third and fourth digits. Imaging revealed extensive soft tissue calcifications consistent with calcinosis cutis. His hospital course was complicated by recurrent infections, osteomyelitis, and gangrene despite antibiotic therapy and wound care, ultimately requiring …

Septic Arthritis Suspected But Pseudogout Confirmed: The Importance Of Early Joint Aspiration And Crystal Analysis, Munazzah Kaleem, Jose Lozano

North Texas GME Research Forum 2026

BACKGROUND/ INTRODUCTION: Septic arthritis present as an acute monoarticular arthritis and is highly suspected in patients with risk factors including DM, ESRD, and bacteremia. As a result, empiric antibiotics are usually started prior to definitive diagnosis. But crystal induced arthropathies closely mimic septic arthritis in their presentation. This case highlights the importance of early arthrocentesis to avoid unnecessary antibiotic treatment.

CASE PRESENTATION: 50-year-old female on antibiotics for MSSA bacteremia presented due to acute onset left hip pain, swelling and decreased range of motion. No trigger was present. PMH included HTN, T2DM and ESRD on HD. She denied fever, chills or …

Tales From The Cryptogenic: A Case Of Recurrent Major Cryptogenic Stroke, Harpreet Matharu, Kennedy Aikins, Kumail Rizvi, Danielle Ford

North Texas GME Research Forum 2026

Background

It is estimated that 30 to 40% of all strokes have no identifiable cause; these are classified as cryptogenic strokes. Often, the unknown nature is secondary to delayed or incomplete investigation of cerebrovascular pathology. At times, strokes are considered truly cryptogenic as extensive stroke workup leads to no identifiable cause or etiology. Acute ischemic strokes in young adults without identifiable risk factors present a diagnostic and therapeutic challenge. Prompt recognition and treatment are critical to optimize outcomes.

Case Presentation

A 32-year-old African American male with a past medical history of a cerebrovascular accident in 2023 at an outside hospital …

True Love: Heart Says To The Kidneys ‘Don’T Fail Me’, Greeshma Molugu, Srinivasan Rajaganapathy, Machaiah Madhrira

North Texas GME Research Forum 2026

Introduction: Valvular calcification is an increasingly important cardiac valvular pathology in end-stage renal disease (ESRD) patients, most frequently involving the aortic and mitral valves. The incidence/prevalence of mitral annular calcification in ESRD patients is about 30%, with mitral stenosis occurring in less than 5%. Various predisposing factors for valvular calcification in ESRD patients include age (median age >/= 60 years), hypertension, diabetes, use of calcitriol and calcium-containing phosphate binders, secondary hyperparathyroidism and duration of dialysis (median duration of >/= 5 years). We present a rare case of a young male with ESRD on peritoneal dialysis (PD) for less than two …

Invasive Pulmonary Aspergillosis: A Two-Year Journey, Jason Woods, Padmaditya Sureddi, Nga Van, Danielle Ford

North Texas GME Research Forum 2026

BACKGROUND: Highly active anti-retroviral therapy (HAART) has decreased the incidence of opportunistic infections among persons with HIV. Invasive aspergillosis specifically is uncommon among individuals with clusters of differentiation 4 (CD4) count >100 cells/mm3. Furthermore, treatment of aspergillosis in the HIV-infected population has not been examined systematically. We report a patient with CD4 count >200 cells/mm3, compliant with HAART therapy who developed invasive pulmonary aspergillosis (IPA) over the course of two years that was successfully treated through a combination of bronchial artery embolization and liposomal amphotericin.

CASE PRESENTATION: A 56-year-old man from southern Africa with four-year history of HIV-1 on HAART …

White Plaques With High Stakes: A Case Of Esophageal Leukoplakia, Boney Lapsiwala, Ritika Sharma, Karthik Kasireddy, Devika Pavuluri, Rupali Prabhukhot, Amjad Awan

North Texas GME Research Forum 2026

Introduction: Esophageal leukoplakia, also termed esophageal epidermoid metaplasia (EEM), is a rare esophageal epithelial disorder characterized by keratinized squamous plaques on esophagogastroduodenoscopy (EGD). With a prevalence of < 0.5%, it is often incidentally identified during evaluation for nonspecific upper gastrointestinal symptoms. EEM is considered a premalignant condition due to its association with esophageal squamous cell carcinoma (SCC), yet management and surveillance strategies remain undefined.

Case Presentation: A 65-year-old woman with hypothyroidism, hypertension, hyperlipidemia, and remote aplastic anemia treated with bone marrow transplantation 35 years prior presented with chronic cough and progressive dysphagia to solids and liquids. She denied tobacco, alcohol, or illicit drug use. No weight loss, abdominal pain, or blood in stool was noted. CT of the neck with contrast revealed curvilinear mucosal hyperenhancement involving the mid to distal thoracic esophagus without lymphadenopathy. Physical examination and …

The Unlikely Case Of Sporadic Immune Thrombotic Thrombocytopenic Purpura With Refractory And Seizure-Like Activity Features: Case Report, Brandon Gremmer, Alain Folefack

North Texas GME Research Forum 2026

Introduction/Background: Thrombotic Thrombocytopenic Purpura (TTP) is a multisystem disease that can lead to multiorgan failure by disseminated mechanical destruction, microangiopathic hemolytic anemia, and thrombocytopenia. Most TTP cases are classified as acquired or hereditary; however, sporadic immune TTP with a refractory episode during the same hospital admission is not well documented in the literature. Furthermore, seizure-like activity during plasma exchange is not a common adverse effect.

Case Presentation: A 35-year-old African American female with no documented medical, surgical, or social history, changes to medications, or lifestyle changes presented with full body fatigue, fever, loss of balance, and confusion. On arrival, labs …

Case Of Toxic Epidermal Necrolysis With High Body Surface Area Involvement And Review Of Predictors Of Severity Of Illness, Hannah R. Riva, Clay J. Cockerell, Muhammad T. Siddique, James M. Cross

North Texas GME Research Forum 2026

BACKGROUND: Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are rare and potentially fatal cutaneous adverse drug reactions. The most common mortality predictor used for TEN is the SCORTEN (Severity-of-Illness Score for Toxic Epidermal Necrolysis). Various scoring systems have been used and are being developed for predicting mortality and guiding treatment in SJS/TEN. We describe a case of TEN with a high body surface area involvement and discuss the scoring predictors for severity of illness.

CASE PRESENTATION: A 63-year-old male was transferred to our burn center for a suspected diagnosis of SJS/TEN. He was intubated prior to arrival. He …

Devising A Protocol For Mri Clearance In Patients With Cardiac Implantable Electronic Devices (Cied), Sienna Luk, Alvin Mathew, Darshan Bhatty, Kamran Rizvi

North Texas GME Research Forum 2026

Background: Magnetic Resonance Imaging (MRI) in patients with Cardiac Implantable Electronic Devices (CIEDs) remains a logistical challenge in many clinical settings. At Medical City Denton, the absence of a standardized institutional policy has led to significant inefficiencies, including prolonged hospital stays and increased healthcare costs. The primary objective of this project was to address these barriers by developing a streamlined, evidence-based protocol to improve care coordination and resource utilization for patients with CIEDs requiring diagnostic imaging.

Methods: Launched in 2026, this pilot initiative utilized a multi-stakeholder approach involving hospitalists, EPs, radiology staff, and device representatives. A core component of the …

Relationship Between Exception Request For Higher Listing Urgency And Aggressiveness In Accepting Heart Offers, Jorim Parmar, Yingxian Liu, Devika Adusumilli, Luke Taylor, Shakir Al-Ezzi, Usman Khan, Claudio Bravo, Claudius Mahr, Song Li

North Texas GME Research Forum 2026

BACKGROUND: Transplant programs may submit exception requests to upgrade a listed patient’s priority, often anticipating a higher likelihood of accepting marginal or high-risk donor organs. This study explores whether exception request status is associated with increased risk tolerance in organ acceptance.

METHODS: We conducted a retrospective analysis using data from the Scientific Registry of Transplant Recipients (SRTR), focusing on adult patients (≥18 years) listed for heart transplantation. Statistical analyses were performed using SAS/STAT 14.1. Descriptive statistics summarized demographic and clinical variables. Baseline characteristics were compared between recipients with and without exception requests. Primary analysis: Mixed-effects linear regression was used to …

Cost Effectiveness Of Lifestyle Program For Diabetes Remission In The Era Of Glp-1, Prasanthi Tondapu, Haasini Sunkavalli, Micaela C. Karlsen, Kara L. Staffier, Kathryn J. Pollard, Surabhi Naik

North Texas GME Research Forum 2026

BACKGROUND: GLP-1 receptor agonists are popular for managing type 2 diabetes (T2D) and obesity but are costly and can result in side effects including weight rebound. Intensive therapeutic lifestyle change (ITLC) programs present an effective alternative, facilitating an HbA1C (A1C) less than 6.5% for 3 months without medication and long-term weight control.

CASE PRESENTATION: We present a 69-year-old Black man with T2D, hypertension, chronic kidney disease, obesity, and sleep apnea. In 2023, he was hospitalized with a blood glucose of 800 mg/dL and A1C 10.8% and discharged on insulin. And, with a BMI of 32 kg/m2 and weight of 238.6 …

A Storm At Both Ends: Hypertensive Emergency Unmaksing C3-Dominant Glomerulonephritis, Karthik Kasireddy, Boney Lapsiwala, Marisha Sharma, Rupali Prabhukhot, Victor Canela

North Texas GME Research Forum 2026

Background: C3 glomerulopathy (C3G) encompasses a group of diseases that result from abnormalities in the alternative pathway of complement regulation, and has been defined by C3 only or C3-dominant immunofluorescence staining seen on renal biopsy. C3G includes C3 glomerulonephritis (C3GN) and dense deposit disease (DDD); the latter of which is characterized ultra-structurally by the presence of highly osmiophilic intramembranous deposits. Both C3GN and DDD often present with a membranoproliferative pattern of glomerular injury, a finding that can also be seen in thrombotic microangiopathy (TMA). Most common causes include infection, autoimmune and monoclonal gammopathy.

Case presentation: A 70-year-old man with hypertension, …

Rare Presentation Of Diffuse B-Cell Lymphoma (Dlbcl), Jasmine M. Silva, Vinay Antin

North Texas GME Research Forum 2026

No abstract provided.