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An Uncommon Cause of Obstructive Jaundice: An Infrequent Neoplasm

A 42-year-old man was admitted to the Johns Hopkins Hospital with right upper quadrant abdominal pain and scleral icterus of 3 weeks duration. The pain was described as aching and cramping in quality that typically occurred after meals. He had no vomiting or diarrhea but did note acholic stools and had more recently developed diffuse […]

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Anchor’s Away: A Case of Apparent Sinusitis

Diagnostic errors, defined as failures to reach timely and accurate explanations for a patient’s presentation, affect the majority of our patients, because most will experience at least one diagnostic error in their lifetime.1 We report the case of a patient who was inappropriately diagnosed with acute bacterial rhinosinusitis and later found to have lymphoma. We use […]

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Herpes Zoster Ophthalmicus: A Review for the Internist

Herpes zoster ophthalmicus occurs due to reactivation of the varicella zoster virus in the ophthalmic branch of the fifth cranial nerve. This disease primarily affects the elderly as well as the immunocompromised and can result in a wide range of ophthalmic morbidity. Systemic antiviral therapy is the mainstay of treatment; however, consultation with an ophthalmologist […]

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Chest Pain in a 39-Year-Old Man: What Could Be the Underlying Cause?

  A 39-year-old man with unremarkable past medical history, but with a positive family history for coronary artery disease, was admitted to the hospital because of persistent arterial hypertension and sudden-onset chest pain in the mid-substernal region with neck radiation. Assessment Results from physical examination were unremarkable. The 12-lead electrocardiogram and the cardiac biomarkers were […]

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Plasma Lactescence in Acute Pancreatitis

A 54-year-old man with history of diabetes mellitus and acute necrotizing pancreatitis was admitted with acute abdominal pain. A computed tomography scan of the abdomen revealed findings consistent with acute pancreatitis. Initial laboratory analysis was unremarkable except for HbA1c 11.1%, lipase of 2195 U/L, and amylase of 234 U/L. Interestingly, the laboratory reported that the […]

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