Internal Medicine Commons^™

A Bullous Eruption In An 81-Year-Old Male, Garrett S. Furth, Christian J. Scheufele, Carlos S. Bahrami, Stephen E. Weis

North Texas GME Research Forum 2024

INTRODUCTION: When a patient presents with a blistering rash arriving at the diagnosis can seem overwhelming. Bullous Pemphigoid (BP) is the most common autoimmune blistering disease and tends to affect older individuals, with a mean age of presentation of eighty. It is caused by antibodies targeting the basement membrane zone, the structure between epidermis and dermis, specifically affecting the BP180 (Type-XVII collagen) and BP230 (a plakin) proteins. Antibody-antigen complexes lead to complement activation and destruction of these transmembrane proteins, causing separation of the epidermis and dermis, and formation of tense, subepidermal blisters and bullae. Identification of key clinical features and …

Clinical Outcomes And 30-Day Readmission After Infective Endocarditis Complicated By Pericardial Effusion, Nameer Ascandar, Charles Boadu, Nancy Osadiaye-Ebomoyi, Haidar Hajeh

West Florida Division GME Research Day 2024

No abstract provided.

Recurrent Pleural Effusion, An Extraarticular Manifestation Of Seronegative Rheumatoid Arthritis, Ronald Spinelle, Jeffin Cherian, Luke Rogers, Domenick Sorresso

West Florida Division GME Research Day 2024

No abstract provided.

Same Day Surgery And Discharge After Cardiac Device Implantation, Aakash Patel, Abraheim Al-Nasseri, Usman Kazi, Mahyar Doraji

West Florida Division GME Research Day 2024

No abstract provided.

Midodrine Use And Mortality In Heart Failure With Reduced Ejection Fraction, Jason Findlay, William Bugni

West Florida Division GME Research Day 2024

No abstract provided.

Saftey Of Doac Treatment In Splanchnic Vein Thrombosis, Allen Swanson, Trevi Mancilla, Hemantha Walaliyadda, Joshua White, Jonathan Sidlow

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

A Retrospective Study Of Procalcitonin Utilization In Clinical Practice, Tanner Norris, Matthew Yurkewicz, Patrick Jenkins, Beth Hicks, Dmitriy Scherbak

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Beyond The Muscle: A Case Presentation On Interstitial Lung Disease In The Setting Of Dermatomyositis, Monique Shamoon, Daria Tarighy, Alejandro Hernandez, Mohamad Saad

East Florida Division GME Research Day 2024

No abstract provided.

Recurrent Non-Sustained Ventricular Tachycardias In A Patient With Suspicion Of Transthyretin Amyloid Cardiomyopathy: A Case Report, Chinar Singh, Meng Xie, Poonam Choudhry, Asif Jawaid

East Florida Division GME Research Day 2024

Objective: This case study aims to highlight the mechanisms, clinical presentation, diagnostic strategies, and management approach utilized for recurrent non-sustained ventricular tachycardias in a patient with suspected cardiac amyloidosis.

Background: Amyloidosis is a group of disorders characterized by the abnormal deposition of amyloid proteins in tissues and organs throughout the body. These proteins aggregate into insoluble fibrils that disrupt normal cellular function, leading to a range of clinical manifestations depending on the affected organs. Cardiac amyloidosis is characterized by the deposition of amyloid fibrils specifically in the myocardial tissue, leading to restrictive cardiomyopathy, progressive heart failure and arrhythmias. Ventricular tachycardia …

Successful Implementation Of Pulmonary Embolism Response Team At Oak Hill Hospital, Shaikh Afaq, Michael Cox, Jaafar Hamdan, Hayder Abidali

West Florida Division GME Research Day 2024

No abstract provided.

Serotonin Syndrome Following Drug Overdose : An Overview, Shruti Verma, Michael L. Ahrens, Shivangi A. Gohil, Scott Rawson, Heather Kort

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Digoxin Toxicity In The Setting Of Alcohol Intoxication, A Case Report, Manuel A. Jimenez, Eliann Reinhardt, Bryan Curry

East Florida Division GME Research Day 2024

No abstract provided.

Risks And Benefits Of Continuing Metformin During Hospitalization, Joel Speir, Sean Shearan, Kevin Trappett, Elizabeth Uba, Kenneth Krell

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Comparing The Risk Of Bleeding In Patients Taking Azithromycin Concomitantly With Different Forms Of Anticoagulation And Antiplatelet Agents, Mohammed Ahmed, Satesh Saroop, Valeria Bernier Jimenez, Fagunkumar Modi

West Florida Division GME Research Day 2024

No abstract provided.

Can Clinical Reasoning Be Taught To Resident Physicians? Evaluating The Effectiveness Of A Clinical Reasoning Course On Residents' Cognitive Knowledge And Analytic Ability, Kenneth Krell, Sreenidhi Chintalapani, Kevin Trappett

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Case Of Metastatic Eshophageal Adenocarcinoma Presenting As Multiple Cavitary Lung Lesions, Michael L. Ahrens, Mala Goyal, Shivangi A. Gohil, Shruti Verma, Pratima K. Singh

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Acute Calcific Tendinitis Of The Longus Colli: A Rare Cause Of Acute Neck Pain, Walker Pride, Kevin Tragesser, Patrick Oshakuade, Elizabeth Hicks

Continental, MidAmerica, & Mountain Divisions GME Research Day 2024

No abstract provided.

Large C. Albicans Vegetation On A Native Tricuspid Valve, Mark Kluever, Neha Patel, Rami Akel

West Florida Division GME Research Day 2024

No abstract provided.

A Rare Case Of Invasive Adenocarcinoma Of The Duodenum And A Bovel Biliary Stent: A Case Report, Sabastiana Sanz, Nasima Mehraban, Bradley Gustafson, Amjad Awan

North Texas GME Research Forum 2024

Adenocarcinoma of the duodenum is a rare but aggressive malignancy making up less than 0.5% of gastrointestinal cancer cases (Tuan et al., 2023), (Cloyd, 2016). We present a rare case of invasive adenocarcinoma of the first part of the duodenum and major papilla that required complex biliary stenting. A 72-year-old male was admitted to our hospital for further workup of gastrointestinal bleeding and 30-pound weight loss. Through imaging it was noted he had lymphadenopathy and biliary dilation. Patient underwent multiple gastrointestinal procedures and was endoscopically found to have a circumferential mass within the ampulla. After unsuccessful cannulation during endoscopic retrograde …

Improving The Screening For Abdominal Aortic Aneurysm At Grand Prairie Internal Medicine Clinic ​, Riddhi H. Patel, Danielle Ford

North Texas GME Research Forum 2024

Introduction: An abdominal aortic aneurysm (AAA) is typically defined as aortic enlargement with a diameter of 3.0 cm or larger. The prevalence of AAA has declined over the past 2 decades among screened men 65 years or older in various European countries. The current prevalence of AAA in the United States is unclear because of the low uptake of screening. This QI project will involve MCA residents and Grand Prairie clinic attending to incorporate screening for abdominal aortic aneurysm guidelines used by USPSTF and attempt to encourage all our established and new patients who fit into the criteria for …

Un-Break My Heart: Improving The Cardiac Rehabilitation Referral Rate, Samer Khalil, Iman Squires, Abed Naser, Akash Patel, Eric Vargas, Manuel Carrazana, Olga Karasik

North Florida Division GME Research Day 2024

No abstract provided.

Patriot Clinic Proton-Pump Inhibitor Review And Therapy De-Escalation (Pcp-Pirate) At The Orlando Va Healthcare System, Sonia Alicea, Emmanuel Magsino, Sriya Reddy, Alfredo Palomino Abella, Faris Alamin, Raj Shah, Ashwini Komarla, David Simmons, Amar Mandalia

North Florida Division GME Research Day 2024

No abstract provided.

Retropharyngeal Abscess Or Malignancy? A Difficult Differential Diagnosis In New Neck Masses, Mary Therese Thomas, Brooke Reese, Mary Carter

South Atlantic Division GME Research Day 2024

No abstract provided.

Ulcerating Plaques Of The Lower Extremities Of A 23-Year-Old Female, Robyn O. Okereke, Christian J. Scheufele, Michael Carletti, Stephen E. Weis, Carlos Bahrami

North Texas GME Research Forum 2024

INTRODUCTION: What should come to mind when any physician sees dark red spots on the legs? If you answered vasculitis, then you are on the right track. Leukocytoclastic vasculitis (LCV) is defined as small vessel inflammation of the dermal capillaries and venules. The clinical hallmark finding of LCV is palpable purpura (raised, round, purple plaques) on the lower extremities. LCV is confirmed by histopathology showing neutrophilic infiltration in the walls of dermal vasculature. Though LCV is the most common cause of clinical vasculitis, the annual incidence of biopsy-proven LCV is approximately 30-45 per million individuals. LCV typically occurs in adults …

Cefepime-Induced Neurotoxicity: A Case Report, Kelsey Decker, Shamael Johar, Vaishnavi Sirekulam, Kedareeshwar Arukala

South Atlantic Division GME Research Day 2024

No abstract provided.

A Challenging Case Of Bilateral Medial Medullary Infarction Resembling Guillain-Barré Syndrome, Alexis Bialousz, Havird Mclean Skalak, Nicholas Carbo, Amanda Westbrook

South Atlantic Division GME Research Day 2024

No abstract provided.

Colorectal Cancer Among Veterans In Urban And Rural Veterans: Can An Integral Healthcare Mitigate Disparities?, Minh Anh Le, Po-Hong Liu, Amar Mandalia, Sergio Romero, Ishak A. Mansi, Moheb Boktor

North Florida Division GME Research Day 2024

No abstract provided.

Gut Fermentation Syndrome: Unraveling The Enigma Of Auto-Brewery Syndrome., Jatin Sadarangani, Vaishnavi Singh, Sathish Karmegam

North Texas GME Research Forum 2024

A disorder known as "auto-brewery syndrome" or "gut fermentation syndrome" occurs when bacteria or fungus in the urinary, oral, or gastrointestinal tract ferment endogenously, producing ethanol. Patients with auto-brewery syndrome frequently report eating a diet heavy in sugar and carbohydrates and exhibit many of the symptoms and indicators of alcohol intoxication while disputing alcohol consumption. Research on Nonalcoholic Fatty Liver Disease indicates that endogenous alcohol synthesis may have bacterial roots; these bacteria may also be the causative agents in GFS. Probiotics, low-carb diets, anti-fungal medications, and antibiotics are currently used as therapies for GFS. Fecal microbiota transplantation may also have …

Mast Cell Colitis Associated With Yersinia Enterocolitica, Olufemi Osikoya, Gregory Brennan

North Texas GME Research Forum 2024

Introduction: Mast cells (MCs) have many functions including regulation of GI epithelial homeostasis, cross talk of the brain gut axis, host immune defenses, and inflammatory pathways. MCs are found in all layers of the GI tract and have been implicated in various gastrointestinal diseases. Although previously described in the literature, mast cell colitis is not considered a distinct clinical entity. This poses a challenge to the gastroenterologist who encounters such pathologic findings. Case Presentation: This is a case of a 76-year-old woman who was referred to the gastroenterology clinic for evaluation of a new diagnosis of colitis. The patient …

Colon Cancer Symptom Progression In A Non-Adherent Patient: A Case Report, Nasima Mehraban, Bradley Gustafson, Saad Hussain, Amjad Awan

North Texas GME Research Forum 2024

BACKGROUND: Colorectal cancer (CRC) is the second leading cause of cancer mortality and third leading cause of incidence worldwide; accounting for one in ten cancer cases and deaths. Thirty-three percent of people between the age of 50 and 75 are not up to date on screening for colon cancer. Depending on the stage of CRC at the time of presentation, the range of chief complaints that bring patients to seek care for this single etiology is diverse, therefore, a thorough work-up is essential for diagnosis. CASE PRESENTATION: A 55-year-old patient presents to the hospital three times over the course …