Internal Medicine Commons^™

Leveraging State Of The Art Simulation-Based Education To Enhance Medical Student Interest In Internal Medicine And Cardiology, Mohamed Abdalaziz, Nicholas Mitchell, Ryan Madder

Conference Presentation Abstracts

Abstract Background: Early clinical exposure plays a critical role in shaping medical student interest, and therefore choice in medical specialty. Traditional curricula offer limited opportunities for hands-on engagement with cardiovascular decision-making and procedures. Simulation-based education may address this gap by providing immersive, low-risk learning experiences. Methods: An internal medicine resident and Cardiology fellow led, faculty-supported simulation curriculum was developed for third- and fourth-year medical students using a state-of-the-art simulation laboratory. Two 75-minute sessions were conducted over a two-month period, with a total of 27 students participating. The first session included a focused electrocardiography didactic emphasizing ST-elevation myocardial infarction (STEMI) recognition, …

Right Atrial Thrombosis In Behcet's Disease Presenting With Tricuspid Inflow Obstruction, Famta Basher Bisher, Thekrayat M. Asad, Sireen Shehadah

Conference Presentation Abstracts

Introduction Behçet’s disease (BD) is a chronic multisystem vasculitis characterized by recurrent mucocutaneous, ocular, vascular, and neurologic manifestations. Cardiac involvement is rare but can be severe, with intracardiac thrombosis representing an uncommon and potentially life-threatening complication. Management is challenging, as first-line medical therapy may be limited by bleeding risk or hemodynamic compromise. Case Presentation A 26-year-old woman with a 9-year history of Behçet’s disease presented with two weeks of progressive dyspnea, palpitations, fever, fatigue, and cough. She denied chest pain, or syncope, or lower extremity swelling. One year prior, she had been hospitalized for pulmonary embolism and was found to …

Targeted Therapy With Braf/Mek Inhibitors And Immune Check Point Inhibitors In Anaplastic Thyroid Cancer - A Case Report, Yagnapriya Ammakola, Muhammad Ibrahim Majeed, Ishmael Jaiyesimi

Conference Presentation Abstracts

Introduction- Anaplastic thyroid carcinoma (ATC) is a highly aggressive malignancy constituting about 1% of all the thyroid neoplasms. It has poor prognosis with median survival of around 3 to 6 months. Recent advancements with targeted therapies have improved the survival outcome in these patients. We report a case of anaplastic transformation of papillary thyroid cancer with BRAF V600E mutation who responded to targeted therapy. Case presentation- A 54 year old male presented with a palpable left sided mass. Labs were unremarkable but imaging with contrast enhanced CT scan showed a 3 cm left thyroid nodule with bilateral cervical lymphadenopathy. Biopsy …

Mycobacterium Chimaera In A Young Patient Without Underlying Cardiac Surgery History, Kate A. Szczesniak, Rakesh Shah, Malitha Hettiarachchi

Conference Presentation Abstracts

Introduction/Objective Mycobacterium chimaera (M. chimaera), within the Mycobacterium Avium Complex (MAC), is a slow-growing nontuberculous mycobacterium (NTM) species that is most often characterized by nonspecific symptoms of night sweats, fever, and fatigue. Due to the nonspecific symptoms of M. chimaera and the rarity of this infection, delayed or misdiagnosis occurs in these patients. Risk factors of contaminated heater-cooler units used in cardiac surgery have been reported; however, cases without this exposure, such as this case, have been cited less commonly. This case of M. chimaera will present a young patient initially presenting with dyspnea who was found to have a …

Esophageal Diverticulum Presenting As Chest Pain In A Patient With Significant Cardiac History: A Diagnostic Challenge, Sujan Shrestha, Alnimer Khabbab, Kamal Khalil, Malitha Hettiarachchi

Conference Presentation Abstracts

Introduction: Esophageal diverticula are uncommon structural abnormalities that may present with nonspecific symptoms such as dysphagia, regurgitation, and chest discomfort. It accounts for < 5% of all cases of dysphagia. In elderly patients with significant cardiac comorbidities, chest pain and dysphagia may be initially attributed to cardiovascular pathology, potentially delaying the correct diagnosis. This case highlights the importance of comprehensive history taking in identifying esophageal diverticulum as an alternative etiology of chronic symptoms. Case presentation: A 77-year-old female with a history of atrial fibrillation, unstable angina, chronic obstructive pulmonary disease, hypertension, and diastolic heart failure presented with chest pain. Given her significant cardiac history, she underwent extensive cardiac evaluation, including serial troponins, electrocardiography, echocardiography, and stress testing, all of which showed no evidence of acute ischemia. Further history revealed intermittent dysphagia to both solids and liquids for over three years, occurring approximately twice weekly. The patient described a sensation of food getting stuck in her throat, occasionally requiring expectoration. Gastroenterology was consulted, and esophagogastroduodenoscopy revealed minimal esophagitis with a distal esophageal diverticulum. The patient was managed conservatively with pantoprazole 40 mg daily, resulting in symptomatic improvement. Discussion: Esophageal diverticula are often associated with underlying esophageal motility disorders and can present with dysphagia to both solids and liquids. Symptoms may mimic or coexist with cardiopulmonary complaints, particularly in elderly patients with multiple comorbidities. While barium esophagography remains the diagnostic modality of choice, endoscopy can identify associated mucosal pathology and confirm the diagnosis. Management is individualized based on symptom severity and diverticulum size, with conservative therapy appropriate for mildly symptomatic patients. Conclusion: This case underscores the importance of considering esophageal diverticulum in the differential diagnosis of chronic dysphagia and chest discomfort, even in patients with significant cardiac disease. Careful history taking and multidisciplinary evaluation are essential to avoid misattribution of symptoms and to ensure timely diagnosis and appropriate management.

A Global Prospective Harmonization Framework For Suicidality, Anhedonia, And Obsessive-Compulsive Symptoms In Psychiatric Genetic Studies: A Cross-Continental Study Within The Ancestral Population Network, Ana Diaz-Zuluaga, Jacey Anderberg, Ana Ramirez-Diaz, Andrea Marques, Catherine Rast, Daniel Bustamante, Deborah Jonker, Johanna Valencia-Echeverry, Stella Gichuru, Lukoye Atwoli

Internal Medicine, East Africa

This study aims to prospectively collect harmonized, quantitative, and dimensional psychiatric phenotypes (suicidality, anhedonia, and obsessive-compulsive symptoms) and information on discrimination, stigma, and unfair treatment in up to 27,500 individuals across diverse ancestries and clinical populations for genetic analysis within the NIMH Ancestral Population Network (APN). Five APN projects are participating in the current study (PUMAS-Paisa, PUMAS-NeuroGAP, KOMOGEN-D, LATINO, and SAX-II), spanning recruitment over 15 countries across the Americas, Africa, and Asia. Participants are being enrolled via the recruitment protocols specific to each participating project. The harmonized clinical battery includes the Columbia-Suicide Severity Scale, Snaith-Hamilton Pleasure Scale, and Florida Obsessive-Compulsive …

Optimizing Antibiotic Strategies With A Clinical Pathway Approach: Enhanced Initiation And De-Escalation In Community-Acquired Pneumonia, Ahmad Behzadpour

HCA Healthcare Journal of Medicine

Background

Community-acquired pneumonia (CAP) remains a leading cause of hospitalization, mortality, and health care expenditure worldwide. Inappropriate use of broad-spectrum antibiotics contributes to antimicrobial resistance, adverse drug events, and increased costs. Antibiotic stewardship and standardized clinical pathways are key strategies to improve prescribing practices.

Methods

This quality improvement (QI) initiative was conducted at a 240-bed tertiary care teaching hospital from January 2023 through January 2025. A CAP-specific digital clinical pathway was developed using Curbside Health® and integrated into the electronic health record (EHR), accessible through a structured order set to support real-time clinical decision-making. The intervention included provider education and …

Eosinophilic Fasciitis Masquerading As Myositis: A Diagnostic Challenge, Jennifer L. Wong, Do, Elizabeth S. Ballner, Do, Mary Elizabeth Swift-Taylor

Books, Presentations, Posters, Etc.

Introduction: Eosinophilic fasciitis (EF), or Shulman’s disease, is a rare disorder of unknown etiology and poorly understood pathogenesis. It is characterized by fibroblast activation and interleukin-driven eosinophilia. Early clinical features include limb or trunk erythema, non-pitting edema, and progressive fascial thickening, often producing an “orange peel” appearance. Eosinophilia is a prominent laboratory finding in the early phase, but diagnosis often requires a full-thickness skin-to-muscle biopsy. Systemic corticosteroids are first-line therapy, with methotrexate as the steroid -sparing agent for refractory disease. We present a unique and diagnostically challenging case of EF confirmed by histopathology. Case Presentation: A 56-year-old man presented with …

Targeting Oxidative Stress In Cadasil: Case Insights And Therapeutic Approaches, Maria Meshreky, Richard Weinberger, Giana Johnson, Andrew Abraham, Jacob Rosendale

The Journal of Integrated Primary Care

Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a rare hereditary small-vessel disease caused by NOTCH3 mutations, leading to recurrent ischemic strokes, cognitive decline, and early-onset dementia. Oxidative stress has been implicated in the pathophysiology of small-vessel cerebrovascular disease, but therapeutic strategies targeting oxidative injury remain limited. We present a 40-year-old female with recurrent ischemic strokes involving the right and left middle cerebral arteries, persistent hypercoagulability of unknown etiology, and no identifiable inherited or acquired thrombophilia. Despite well-controlled blood pressure and standard medical management, the patient remains at high risk for cerebrovascular injury. An extensive review of …

Bilateral Intracranial Subdural Hematoma Following Epidural Anesthesia, Eric B. Cox, Adaeza Onuoha

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

From Hard Hat To Headache: Cryptococcal Empyema And Meningitis In A Newly Diagnosed Hiv-Positive Construction Worker, Sebastian Echegaray, Collin Vargas, Vy Ngo

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Fatal Ochrobactrum Anthropi Bacteremia Following Intravenous Stem Cell Therapy In Immunocompetent Patient, Daler Kudratov, Wendy Martinez, Jonathan Barnett

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Coexisting Systemic Lupus Erythematosus And Acquired Thrombotic Thrombocytopenic Purpura In A Clinically Stable Patient With Class V Lupus Nephritis, Anabel Al Abdallah, Nimmy Joy, Rodrigo Alfaro

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Mme (Mini Medical Education): A Preliminary Study Of A Targeted Curriculum To Improve Resident Knowledge And Clinical Confidence, Andrea Francis, Andres Vivar, Paul Mathew

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

A Case Of Secondary Hemophagocytic Lymphohistiocytosis, Nafis Deen, Sarita Thanedar, Aaron De La Cruz

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Trends And Demographic Disparities In Septicemia-Associated Cardiac Arrest Mortality In The United States, 1999–2023, Muhammad Owais, Maham Mehfooz, Hamza Nazir, Preeti Advani, Roha Riaz, Khanij Arya, Javeria Nawaz, Syed Hadi Raza Rizvi, Murtaza Aslam, Usman Nazeer, Jairo Melo, Bravein Amalakuhan

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Recurrent Ventricular Tachycardia In Young Hcm Patient With Icd, Michael Rollins, Garza, Laura Preece

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Type 2 Diabetes Mellitus And Early Peg Tube Complications, Eric E. Romero Rodriguez, Adrian Reta, Angelo Manuel Piazza, Kuljot Bansi

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

Structural Degeneration Of The Neoaortic Valve Leading To Pseudoaneurysm And Neurologic Complications Post-Ross Procedure, Cassandra Millan, Sarita Thanedar, Chandra Kunavarapu

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.

The Future Of Right-Sided Endocarditis?: A Case Report Of Tricuspid Valve Endocarditis Treated With Angiovac And Review Of Current Literature, Saad Masud, Gongkai Liu, Hayyan Yousuf, Bravein Amalakuhan

Central & West Texas and San Antonio GME Research Day 2026

No abstract provided.