Internal Medicine Commons^™

Where’S Adam? Successful Treatment Of Covid-19 Vaccine-Related Refractory Thrombotic Thrombocytopenic Purpura, Christopher Fontela, Alfredo Toll, Jose Fernandez, Gabriel Barciela-Perez, Jorge Diaz, Greisy Curbelo-Sesin, Ilde Manuel Lee, Jose Gascon

East Florida Division GME Research Day 2023

A 54-year-old man with a medical history notable for hypertension and type 2 diabetes mellitus presented with altered mental status. Initial assessment revealed altered consciousness, aphasia, and diffuse generalized petechiae. Having recently migrated from Colombia, he had received four doses of the Pfizer COVID-19 vaccine, with the last dose administered one month prior to presentation. Laboratory results indicated severe thrombocytopenia (platelet count: 3), microangiopathic hemolytic anemia, acute myocardial, liver, and kidney injury, prompting a presumptive diagnosis of thrombotic thrombocytopenic purpura (TTP). Confirmation was achieved through an ADAMTS13 level of less than 2 percent. Despite initiating high-dose solumedrol and emergent plasmapheresis, …

A Case Of Coxsackievirus Type B-Induced Myocarditis Presenting With Gi Symptoms, Daniel Karpel, Jason Nguyen, Cristina Benites, Mohammed Akram, Francini Alcocer-Guzman, Evelyn Garcia, Shany Quevedo, Ambar Sekulits, Livasky Concepcion Perez

East Florida Division GME Research Day 2023

Please see supplemental content for full abstract with references.

Myocarditis affects 1.5 million people worldwide and in chronic forms can lead to heart failure. This inflammatory disorder is a primary cause of dilated cardiomyopathy globally and is frequently a complication of viral infections. Although Coxsackievirus B3 continues to be a prominent causative agent, further exploration has discovered a number of Coxsackie serotypes responsible for myocarditis. Despite being a well-known contributor to congestive heart failure, there is a lack of conventional techniques available to aid in diagnosis, making diagnosing acute viral myocarditis a complex and tedious process. We discuss the case …

When Hypothyroidism Goes Unchecked, Jeong Hwan J. Kim, Yasimin Taheri, Matt Rostami, Ian Joel, Jasprit Takher

Far West Division GME Research Day 2023

No abstract provided.

A Young Case Of Giant Cell Arteritis, Tricia O'Brien, Philip Mesquita, Zahid Chaudhry

East Florida Division GME Research Day 2023

Introduction: Giant Cell Arteritis is condition that commonly affects patients between the ages of 70 and 80 years old. It rarely affects those younger than 50 years of age.

Description: A 40-year-old African American woman, who had previously been diagnosed with Giant Cell Arthritis via temporal artery biopsy at age 33, presented to the emergency department due to facial and arm numbness and throbbing headache. Her ESR was markedly elevated and she was placed on prednisone.

Discussion: The incidence of Giant Cell Arthritis is between 5.8 to 31.3 per 100,000 in the population. This disease affects women 2-3 times more …

A Stiff Lower Lip, Tricia O'Brien, Philip Mesquita, Zahid Chaudry

East Florida Division GME Research Day 2023

No abstract available.

Subacute Stroke Like Presentation Likely Due To Disseminated Histoplasmosis In An Immunocompromised Patient, Ashley R. Diaz, Priya Mohan, Utmitha Konda, Alfonso Manotas, Issac Ichoa

East Florida Division GME Research Day 2023

Histoplasmosis capsulatum is an opportunistic fungal infection that is largely asymptomatic and found to have nonspecific signs and symptoms. It predominates in Central and North America, and is one of the leading causes of hospitalization among the fungal family. However, in the right host, such as in this case, a patient with significant immunosuppression can develop serious manifestations as it disseminates outside of the pulmonary system. The challenging element of disseminated histoplasmosis is that despite proper treatment immunocompromised patients will frequently relapse with worsening presentation. There is limited literature on subacute stroke-like presentation in a patient with chronic infection of …

Save A Limb: Potential Utility Of Empiric Plasmapheresis For Recurrent Brachial Artery Thrombosis And Acute Limb Ischemia Following Left Heart Catheterization, Peter Harrill, Mariel Duchow, Levy Amar

East Florida Division GME Research Day 2023

Please see supplemental content for abstract with figures.

Background: Although radial artery thrombosis following left-sided cardiac catheterization is a recognized complication, with an incidence reported anywhere from 1-10%, there are very few reports of recurrent brachial artery thrombosis and acute limb ischemia following such a procedure.

Case: 64-year-old female with past medical history of a previous CVA of unknown etiology with no residual deficits and hyperlipidemia who was initially admitted for management of a suspected NSTEMI. She was started on an IV Heparin infusion prior to undergoing a Left Heart Catheterization, which was normal, using right radial artery access. Within …

An Intersting Presentation Of Angina Due To Left Posterolateral To Right Posterolateral Coronary Artery Fistula, Vivek Nadipalli, Ahmed Mahmood, Muhammad Uzair Lodhi, Bilal Hussain, Sohail Khan, Christel Cuevas, Thomas Alexander

Gulf Coast Division GME Research Day 2023

No abstract provided.

Utility Of Daily Cbc In Hospitalized Patients, Lauren Howard, Kayla Engstrom, Aisha Khan, Andrew Vest, Carlos Vargas

Gulf Coast Division GME Research Day 2023

No abstract provided.

Sudden Onset Ams, Focal Weakness, Fever And Aphasia Due To Intracranial Subdural Empyema In Left Temporo-Parietal Lobe, Lily Hyunjung Lim, Menachem M. Nagar, Pallavi Aneja

East Florida Division GME Research Day 2023

Intracranial subdural empyema (ISE) is a rare infection of brain, which occurs when pus is collectively located in the space between dura and arachnoid matter. In the past, its mortality was nearly 100%, if it was not treated appropriately within 24-48 hours. Thanks to improvement of diagnostic modalities and treatment, its mortality has dramatically decreased. Though, it can still cause a devastating consequence if it is not managed in a timely manner. The common etiology of ISE is different depending on the age group. In younger patients, it occurs frequently as a complication of infection in neighboring structures like sinusitis …

Pregnancy Induced Pancreatitis In The Setting Of Medical Abortion And Severe Hyponatremia, Nd Ekpa, Sheila Chandrahas, Randy Chung

Gulf Coast Division GME Research Day 2023

No abstract provided.

A Rare Case Of Right Atrial Appendage Mass In Patient With Recurrent Methicillin-Resistant Staphylococcus Aureus Bacteremia, Vivek Nadipalli, Ahmed Mahmood, Thomas Alexander

Gulf Coast Division GME Research Day 2023

No abstract provided.

Intracerebral Hemorrhage And Reversible Cerebral Vasoconstriction Syndrome Ina Patient With Covid-19, Matthew Bear, Branden Wilson, Aswin Srinivasan, Amar Hasan, Salman Alim, Mohamad Ezzeldin

Gulf Coast Division GME Research Day 2023

No abstract provided.

A Resident Led Newsletter Is A Powerful Communication Tool, Jonathan Brown, Rachel Hogan, An Dao, Zuhair Ali, Rajeev Raghavan

Gulf Coast Division GME Research Day 2023

No abstract provided.

Fatal Atrio-Esophageal Fistula Presenting As New Onset Seizures, Hytham Rashid, Jonathan Brown, Eryn Percenti, Justin Saunders, Sivatej Sarva

Gulf Coast Division GME Research Day 2023

No abstract provided.

Rare Case Of Chylopericardium Status Post Coronary Artery Bypass Graft, Hytham Rashid, Harris R. Khawaja, Ashley Charales, Essam Girgawy, Ramesh Kesavan, Michael Daniel

Gulf Coast Division GME Research Day 2023

No abstract provided.

Appeal: Advocating Polst Education And Adherence At End Of Life, Carlo Reyes, Susan Hickman, Neil Gerts, Mandeep Sablok, Jasprit Takher

Far West Division GME Research Day 2023

No abstract provided.

A Late Onset Leg Rash, Unique Janeway Lesions Or Jarisch Herxheimer Reaction?, Andrew Kim, Cristian Valdez, Tony Alarcon

Far West Division GME Research Day 2023

No abstract provided.

Improving Nursing Staff And House Staff Communication Within A Technology Platform (Imobile), Raisa Anwer, Phuong Nguyen, Vidhi Patel, Nadine Bos

Capital Division GME Research Day 2023

No abstract provided.

A Rare Educational Case Of Idiopathic Cutaneous Leukocytoclastic Vasculitis, Shruthi Vijayalakshmi, Shreyan A. Patel, Admir Syla

Capital Division GME Research Day 2023

No abstract provided.