Internal Medicine Commons^™

Anti-Pd-1 Monoclonal Antibody Induced Diabetic Ketoacidosis In Melanoma, Boney Lapsiwala, Jacqueline Bekhit, Indira Tata, Vibhuti Veeranna

North Texas Research Forum 2025

Background: Immune checkpoint inhibitors (ICIs), including pembrolizumab, are increasingly used in cancer therapy, particularly for melanoma. While effective, these agents are associated with various immune-related adverse events (IRAEs), including endocrine disorders like diabetic ketoacidosis (DKA). This report aims to contribute to the understanding of pembrolizumab-induced DKA, especially in patients with pre-existing prediabetes. Case Presentation: A 78-year-old male with a history of melanoma, prediabetes, and other comorbidities developed DKA after 1.5 years of pembrolizumab treatment. He presented with symptoms of weakness, thirst, dry mouth, and diarrhea, alongside severe hyperglycemia and metabolic acidosis. Diagnostic workup confirmed DKA, and his clinical improvement followed …

Gastrografin Enema To The Rescue Of The Glorious Cecal Bascule, Dominique Pean, Bushra Bangash, Guntash Khasria, Ismail Hader

Gulf Coast Division GME Research Day 2025

No abstract provided.

A Rare Case Of Brucellosis Relapse, Rabia Mahfooz, Grant Patterson, Annmary Behanan, Babivigasan Gunasegaran

Gulf Coast Division GME Research Day 2025

No abstract provided.

Recurrent Syncope In A Young Adult With Postural Orthostatictachycardia Syndrome (Pots): A Diagnostic And Therapeutic Challenge, Syed Raza, Shuchita Jhaveri, Neethu George, Julian Nguyen

Gulf Coast Division GME Research Day 2025

No abstract provided.

Immune Related Cardiac Cardiac Tamponade Triggered By Pd-L1 Blockade In Breast Cancer: A Case Report, Luis Salcedo, Ivan Mogollon, Francisco Arias, Jose Donis, Michelle Lopez

Gulf Coast Division GME Research Day 2025

No abstract provided.

Atn Masquerading Rapidly Progressive Glomerulonephritis: Atypical Presentation Of P-Anca Associated Vasculitis With Rpgn, Nimmy Joy, Anabel Al Abdallah, Andrea Francis, Saurabh Pande

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Occlusive Thrombosis Of Superior Mesenteric And Portal Veins, Radhika Mohan, Genevieve Mccloskey, Curtis Wong, Hedaya Othman, Valerie Sinkler

South Atlantic Division GME Research Day 2025

No abstract provided.

A Case Of Dress Syndrome Following Recurrent Hardware-Related Knee Infection: Diagnosis, Management, And Recovery, Cooper Alden Josephs, Himani Patel, James Everhart

South Atlantic Division GME Research Day 2025

No abstract provided.

Impact Of Fluid Balance On Clinical Outcomes In Icu Patients W. Pulmonary Arterial Hypertension, Geran Maule, John Rickards, Abdallah Rayyan, Moh'd Alamin Daise, Kobina Essilfie-Quaye, Peters Okonoboh

North Florida Division GME Research Day 2025

No abstract provided.

Life Over Limb: A Case Of Rapidly Rrogressive Necrotizing Fasciitis, Olesya A. Balashova, Adam Lerchenfeld, Rahul Ramakrishnan, Ashley Diaz, Anna Felizcek, Daniel Heller

East Florida Division GME Research Day 2025

No abstract provided.

Platypnea-Orthodeoxia Syndrome In A Case Of Septal Occlusion Device Migration, Bike Ozkan, Richard Shalmiyev, Adam Devine, Michael Pelekhach, Siddarth Kathuria, Daniel Heller, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction

Platypnea-orthodeoxia syndrome (POS) is defined by dyspnea and hypoxemia in the upright position, which improves upon recumbency. While often linked with hepatopulmonary syndrome, intracardiac etiologies, particularly a patent foramen ovale (PFO), may also be responsible. PFOs are typically managed with device closure, and while rare, device migration can occur unbeknownst to the patient with resultant critical sequelae.

Methods

Here, we present the case of an 89-year-old female with a medical history of hypertension, diabetes, and coronary artery disease status post PCI, who arrived with severe dyspnea and was subsequently intubated for profound hypoxia. A chest CT angiogram ruled out …

Oil And Air Don’T Mix: Vitamin E Acetate In Evali, Angelo Lopez-Lacayo, Jordan Taylor-Bentley, Josef Masseli, Michelle Silva, Christy Diaz, Daniel Zapata

East Florida Division GME Research Day 2025

Introduction: Electronic cigarette or vaping-associated lung injury (EVALI) is an acute or subacute condition characterized by acute respiratory symptoms and bilateral pulmonary infiltrates seen in patients who are exposed to electronic cigarettes or vapes. The condition has been strongly linked to inhalation of aerosolized vitamin E acetate, particularly in THC-containing e-cigarette products. Despite regulation of vitamin E acetate in the production of electronic vapes, it continues to be a byproduct of EVALI due to counterfeit electronic vapes. Clinically, patients with EVALI present in various ways but are not limited to fever, shortness of breath, cough, chills, body aches, pleuritic chest …

Lactate/Albumin And Rdw/Albumin Ratios For Mortality And Readmission In Post-Mi Heart Failure, Amogh Killedar, Hamza Khan, Henry Cusnir

East Florida Division GME Research Day 2025

BACKGROUND Robust biomarkers that capture the combined effects of inflammation and tissue hypoperfusion, are needed to refine post–acute myocardial infarction (AMI) risk stratification—especially in the large subset that develops congestive heart failure (CHF). Two emerging candidates are the lactate/albumin ratio (LAR) and the red-cell-distribution-width/albumin ratio (RAR). Separate studies have linked each ratio to short- and long-term mortality in critical illness, AMI, and heart failure, yet no work has directly compared their performance together. We addressed this evidence gap in a large, multi-hospital dataset.

METHODS We performed a retrospective analysis of 8 115 encounters drawn from the HCA Healthcare database (2016-2024). …

Of Bugs And Bruton's: Infection Risks In Btki Therapy, Musa Kiyani, Owen Clanahan

East Florida Division GME Research Day 2025

No abstract provided.

A Case Of Recurrent Pleural Effusion Secondary To Thoracic Endometriosis Syndrome After Discontinuation Of Oral Contraceptives, Kevin Gopala-Rao, Luis Santiesteban, Carmen Tormo Carrillo, Christian Almanzar Zorilla, Mauricio Danckers

East Florida Division GME Research Day 2025

Introduction: Thoracic endometriosis syndrome (TES) is a rare condition in which functional endometrial tissue spreads to the thoracic cavity. Manifestations of TES include catamenial hemoptysis, pneumothorax, and pleural effusions along with symptoms of dyspnea, cough, and pleuritic chest pain.1 Approximately 6 to 10% of women of reproductive-age women develop TES with concurrent pelvic endometriosis in 80% of patients.2 Treatment of TES includes medical management with progesterone-based oral contraceptive pills (OCPs) and surgical management involving cardiothoracic surgery. We present a case of recurrent pleural effusions in a patient who was non-compliant with medical management of TES. Methods: Data was collected during …

The Demographics Of Vasopressor Requirements In Covid-19 Patients, Sammy R. Ghaoui, Paloma A. Molina, Romina Flores, Adela Bazbaz, Daryelle Varon, Joseph Varon

Gulf Coast Division GME Research Day 2025

No abstract provided.

Cryptococcal Meningitis In A Patient With Multiple Sclerosis On Fingolimod, Syed Hassan Amir, Teena Mathew

North Texas Research Forum 2025

Background: There are a host of pathogens that thrive only when the host is weakened enough to be susceptible – Cryptococcus is one such organism that causes fatal meningitis, primarily in HIV patients. Those immunocompromised by other means are also susceptible. Among them, patients with multiple sclerosis (MS) pose a significant challenge as what may initially be considered an MS flare could mask a serious underlying infection. Objective: This case study discusses an MS patient on Fingolimod, an immunosuppressant, that likely made them vulnerable to cryptococcal meningitis. Pathogenesis: Cryptococci are encapsulated yeast that enter the body via inhalation of spores …

When Osteoporosis Masks Multiple Myeloma: A Diagnostic Pitfall, Neil Maithel, Rabia Mahfooz, Easlie Chen, Ali Asghar, Aftab Mahmood

Gulf Coast Division GME Research Day 2025

No abstract provided.

Severe Hypercalcemia In A Patient Taking Chronic Shark Fin Supplements, Sumanth Reddy, Bishwas Upadhyay

North Texas Research Forum 2025

BACKGROUND/INTRODUCTION: In this study, we discuss a case of an 86 year old Vietnamese female who presents with severe hypercalcemia, 15.0, who presented with progressively worsening physical debility which resulted in the patient being wheelchair bound after being found to be taking chronic calcium supplements. Hypercalcemia is a metabolic abnormality that is known to cause muscle weakness, changes in sensorium, dehydrations, nausea, anorexia, polyuria, constipation, fatigue, and depression. CASE PRESENTATION: Patient is an 85 year old female with significant medical history of osteoarthritis who presented to the emergency department for generalized fatigue for the past 2 weeks. Patient reports that …

Hemophagocytic Lymphohistiocytosis In A 55-Year-Old Female With Dengue Fever: A Case Report, Martin Twumampofo, Huy Vuong, Karen Valadez-Cuen, Oswaldo Renteria, Hector Zepeda

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

The Importance Of Early Source Control: A Case Of Resistant Mrsa, Jack Demirjian, Paul Mathew

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Pemetrexed Induced Pancolitis: A Case Report, Jack Demirjian, Christina Tompkins, Amelia Mellor, Aasia Khan

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Not Your Average Syncope: A Case Of Bifascicular Block, Shuchita Jhaveri, Maria Amigo, Zahoor Khan, Marloe Prince

Gulf Coast Division GME Research Day 2025

No abstract provided.

Should Sglt-2 Inhibitors Be Withheld In The Hospital Setting Due To Increasing Prevalence Of Euglycemic Dka, Raja Hamsa Chitturi, Franklin Hernandez, Charmaine Butt, Karthikram Komanduri, Mitra Chandan

North Florida Division GME Research Day 2025

No abstract provided.

Fibrillary Glomerulonephritis Associated With Hepatitis C: A Case Report Of Progression To End-Stage Renal Disease, Boney Lapsiwala, Karthik Kasireddy, Marisha Sharma, Mayank Singh, Vaishnavi Singh, Victor Canela

North Texas Research Forum 2025

A Case of DNAJB9 with rapid renal progression to End-Stage Renal Disease in a patient with previously treated HCV Background Fibrillary glomerulonephritis (FGN) is a rare and progressive kidney disease, accounting for 0.5% to 1.4% of native kidney biopsies. It is characterized by non-amyloid fibrillar deposits in the extracellular matrix. Although historically regarded as idiopathic, recent studies have revealed associations with autoimmune diseases, malignancies, and Hepatitis C virus (HCV) infection. DNAJB9, a proteomic marker identified through mass spectrometry, has been consistently found in FGN cases, regardless of congophilia. This case illustrates FGN in a patient with a history of successfully …

Under-Utilization Of Non-Selective Beta-Blocker In Patients With Clinically Significant Portal Hypertension & Esophageal Varices, Sohaib Ahmed, Ana Moraga, Syed Usman Mumtaz, Varun Mehta, Boran Mao, Juan Pablo Meruvia, Amar Mandalia, Shamol Williams

North Florida Division GME Research Day 2025

No abstract provided.

Thyroid Storm And High Output Heart Failure, A Perfect Storm, Gunjan Mundhra, Haris Ahmed, Rebecca Schuyler, Karina Bidani, Justin Gisel

South Atlantic Division GME Research Day 2025

No abstract provided.

Herpes Zoster? Pfo? Or Both?, Thomas Mizera, Amelia Mellor, Vinh Ngo, Micheline Tantchou, Oscar Munoz

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

Granulomatosis With Polyangitis Presenting As Cavernous Sinus Thrombosis And Oculomotor Nerve Palsy: A Case Report, Kempes Chan, Nanda Gopalan

Central & West Texas and San Antonio GME Research Day 2025

No abstract provided.

A Rare Case Of Prolonged Life Expectancy In A Patient With Duchenne Muscular Dystrophy, Sara Shahid, Mina Choudhry, Anam Zara

Gulf Coast Division GME Research Day 2025

No abstract provided.