Brady Pregerson, MD

A woman in her late 70’s with a history of Afib on Xarelto is brought by ambulance to the hospital for 12 hours of coffee ground emesis and epigastric pain. She denies melena, bleeding, fever, or diarrhea.

Vital signs are normal except for pulse 102

Physical exam is otherwise normal except for epigastric tenderness and occasional mild coffee ground emesis

: normal except for WBC 13. Hb normal at 12.6

: normal except for bicarb of 38, sodium 130, glucose 155

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Our latest case report from Brady Pregerson, MD, features a woman in her late 70s with a history of AF on rivaroxaban brought to the hospital for 12 hours of coffee ground emesis and epigastric pain. Can you determine the correct diagnosis?

Endocrine Case Report: Coffee Ground Emesis

A man in his 30s with a history of type 1 diabetes mellitus on insulin presents to the emergency department for left index finger pain and swelling. He states about a week ago he had a puncture wound to the tip of that finger from a frayed bike cable. He removed a foreign body but the pain never went away. In the past 24-36 hours it has become rapidly more painful and swollen and he can’t straighten his finger. He denies any drainage, fever, or other complaints.

Vital signs are normal. Physical exam is normal except for the images below:


: WBC: 14. Glucose: 220; Bicarb: 21; Other labs normal

: Hand x-ray showed no foreign body, gas, or bony involvement

Our latest case report from Brady Pregerson, MD, features a man in his 30s with a history of type 1 diabetes mellitus on insulin presenting to the emergency department for left index finger pain and swelling. Can you determine the correct diagnosis?

Endocrine Case Report:  Finger Swelling in T1D

A man in his mid-30’s with a medical history significant for obesity and diabetes on an insulin pump presents to the hospital with 4 days of gradually worsening right foot pain and swelling. He denies any fever but has had intermittent chills and also feels a bit of generalized weakness. He denies any other complaints.

Vital signs are normal except for a pulse of 118 and a BP of 104/51 mmHg. Physical exam is otherwise normal except for a red swollen foot.

: normal except for glucose 431, bicarb 19

Our latest endocrine case report features a man in his mid-30’s with a medical history significant for obesity and diabetes on an insulin pump presenting to the hospital with 4 days of gradually worsening right foot pain and swelling. Can you determine the correct diagnosis?

Endocrine Case Report: Foot Infection

A man in his 60’s with a history of diabetes and cirrhosis presents to the hospital with 2 weeks of RUQ pain radiating to the back with constipation and now 2 days of vomiting. He was triaged as having RLQ pain, not RUQ pain. He denies any fever, bleeding, melena or other complaints.

Vital signs are normal except for a pulse of 101. Physical exam is otherwise normal except for epigastric but not RLQ tenderness

: normal except for sodium of 128. LFT’s mildly elevated

The latest case report from Brady Pregerson, MD, features a man in his 60s with a history of diabetes and cirrhosis presenting with 2 weeks of right upper quadrant pain with constipation and 2 days of vomiting. Can you determine the correct diagnosis?

Endocrine Case Report: Cirrhotic with Epigastric Pain

A man in his mid-70’s with a recent UTI is brought to the hospital by ambulance with a glucose of 30 after family called 911 for generalized weakness. Medics gave an amp of D50 and he gradually became less weak. He is 4 days into the second course of antibiotics for a UTI but denies any fever, pain, or other complaints. He has a history of Parkinson’s and HTN, but no diabetes or other endocrine conditions.

Vital signs are normal. Physical exam is non-focal

The latest endocrine case report from Brady Pregerson, MD, features a man in his mid-70’s with a recent UTI brought to the hospital with a glucose of 30 mg/dL and reports of generalized weakness. Can you determine the correct diagnosis?

Endocrine Case Report: Glucose of 30 mg/dL

A man in his 60’s with a history of DM and left BKA is brought to the hospital by his wife for a pink smelly right foot that has been getting gradually worse for the past 2 weeks. He did not want to see a doctor but the smell got so bad that his wife finally called 911. He denies any fever, recent trauma or other complaints though he says he broke the same foot a long time ago in a motorcycle accident.

Vital signs are normal except for a pulse of 118. The temperature is 99.1. Physical exam is otherwise normal except for a BKA on the opposite leg and a stinky erythematous right foot with a large black eschar.

Glucose 350, bicarb is normal, lactate 2.5, creatinine 2.1, WBC 32K, 12 bands

The latest endocrine case report from Brady Pregerson, MD, features a man in his 60s with diabetes and left below-knee amputation for a smelly right foot that has been getting gradually worse for 2 weeks. Check out the report, labs, and imaging and see if you can determine the correct diagnosis.