Acute transverse myelitis after DTP vaccine. T2-weighted MRI showing diffuse cord edema, signal hyperintensity (C3-T6). From PMID: 16317420. Thanks to Dr. Nguyen-Fa for a great presentation on transverse myelitis! Learning points: Ddx for upper + lower motor neuron symptoms includes ALS,…

Thanks to Dr. John Feng for a great presentation on severe hypothyroidism Learning Points: Symptoms include: fatigue, cold intolerance, constipation, depression, weight gain, dry skin, hair thinning or loss and memory impairment Exam findings include: bradycardia, diastolic HTN, coarse facies,…

Features and etiology of infectious proctitis in MSM. From PMID: 24275725 Thanks Dr. Jimenez for a great morning report discussing causes of infectious proctitis.  Learning points: Causes of rectal pain include infectious etiologies, IBD, trauma, anal fissures, hemorrhoids. In HIV-positive patients,…

It's October already! Here are some fun events for the weekend: San Gabriel Dumpling and Beer Fest is tonight (10/1) at 6pm. It's being billed as a "local twist on Oktoberfest." Donut lovers should head out to the Madison Avenue Graffiti…

Medical illustration of non-typhoid salmonella. From: CDC.gov Thanks to Dr. Ponec for a great morning report on non-typhoid salmonella causing severe sepsis and diarrhea. Learning points: Assessing diarrhea: Duration: acute (<14d) vs. persistent (14-30d) vs. chronic (>30d) If acute, judge…

Learning Points: - Ectopic thoracic endometrial tissue most commonly presents in young women as a right sided catamenial pneumothorax (~70%) or catamenial hemothorax (~15%). -One needs a high clinical suspicion for diagnosis, and patients with suspected thoracic endometriosis should undergo contrast-enhanced CT scan…

Thank you Dr. Tony Hung for well organized and informative presentation on malaria! Learning Points:  1) Among returning travelers presenting with a systemic febrile illness, the most common specific diagnoses are: Malaria Dengue fever Mononucleosis (2/2 EBV vs. CMV) Rickettsial…

Thank you to Dr. Nandita Sriram for an excellent review of vertigo! Learning Points: -- Taking a good history is pertinent in distinguishing between dizziness vs true vertigo -- Differentiate between peripheral vs central etiologies of vertigo Peripheral causes: BPPV,…

Thank you Dr. Jarod DuVall on a very interesting case in a non-diabetic patient presenting with hypoglycemia Learning Points:  True hypoglycemia in a patient without underlying diabetes must fulfill the Whipple's triad: Presence of symptoms suggestive of hypoglycemia (e.g. diaphoresis,…

Learning Points: General approach Obtaining a thorough history is key in assessing altered mental status When examining patients with fevers, headaches and altered mental status, make sure to conduct a Jolt accentuation test in addition to Kernig's and Brudzinski's  to…