The Case:

The patient was a 27-year-old male with a past medical history of insulin-dependent type 1 diabetes and prior ICU hospitalization in 2006, presenting with one day of isolated right lower quadrant pain. He endorsed compliance with his insulin. The patient was afebrile with isolated tachycardia to 120 bpm without hypotension or other vital sign abnormalities. His exam was notable for McBurney’s point tenderness and left lower extremity varicose veins. The patient’s blood work was notable for hyperglycemia without ketosis or acidosis in addition to mild leukocytosis. A CT abdomen-pelvis was notable for uncomplicated appendicitis and was incidentally positive for intravascular foreign bodies within the inferior vena cava.

Jose Reyes, MD

Here is a quick recap of the management of decompensated heart failure. Remember to always look for a reason for decompensation given the cause can be more deadly than the effect.

Morgan Kemerling, MS4

Here you have a 68-year-old male with a PMHx of PE on apixaban, HTN presents with fatigue and several days of diarrhea. You are handed the following ECG. What is your interpretation?

Alejandro Negrete, MD