Internal Medicine Commons^™

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.

Assessing The Effectiveness Of A Rapid Response Training Course, Nasima Mehraban, Caroline Brooke, Vivek Punjabi, Veeranna Vibhuti

North Texas Research Forum 2025

Introduction: Rapid response teams are crucial in healthcare settings for managing clinical emergencies. To enhance the preparedness of interns in handling such situations, we developed a rapid response training course. This study aimed to evaluate the course's effectiveness by examining changes in residents' self-reported confidence levels before and after completing the training. Methods: A group of interns participated in five simulated rapid response scenarios. Before the training, participants rated their confidence level on a scale from 1 (not confident in running a rapid response) to 10 (very confident). Following the training, they reassessed their confidence level. Pre- and post-training ratings …

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 …

Bridging Knowledge And Practice: Exploring The Medical City Arlington Internal Medicine Handbook, Laura Montoya, Evangelista Ezenduka, Shivani Agarwal, Mike Nguyen, Fatima Safi, Nikhil Madhav, Dallin Beus, George Yeung, Hayan Kundi

North Texas Research Forum 2025

Internal medicine residents face a wide range of challenging medical conditions during their training and need to be equipped with both the knowledge and flexibility to handle whatever comes their way. As part of a collaborative initiative, we present the Medical City Arlington Internal Medicine Handbook, a practical resource built by residents, for residents. This handbook brings together practical insights, evidence-based practices, and specialized clinical expertise, all with the goal of enhancing the diagnostic and treatment skills of internal medicine practitioners. It covers a broad spectrum of conditions, from common ailments to rare and complex diseases, and provides in-depth management …

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.