Brady Pregerson, MD

A woman in her early 40s with a history of diabetes mellitus presents to the emergency department for a flu-like illness with multiple symptoms. This morning she woke with chills, subjective fever, cough, and headache, and vomited once. She is also feeling weak all over and has dyspnea, pleuritic chest pain, and epigastric pain. She denies diarrhea, dysuria, or other symptoms.

 Temperature 102.3, Pulse 126, BP 105/45, Pulse-ox 98%. 

 is notable for a positive jolt sign but no photophobia or neck stiffness, clear lungs, epigastric tenderness and tachycardia.

Chem 7: normal except for glucose 203 and bicarb of 21

Other: UA normal. LP to rule out meningitis normal.

Re-eval: Feels a little better. Repeat vitals: Temp 100.1, HR 97, BP 96/55

Diagnose a viral syndrome and discharge home

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Our latest endocrine case report features a woman in her 40s with a history of diabetes mellitus presenting with flu-like illness with multiple symptoms. Can you determine the correct diagnosis?

Endocrine Case Report: What's the Dif?

A patient in their mid-70s with a history of obesity, hypertension, osteoporosis, and prior ankle surgery presents to the urgent care with right lateral foot pain ongoing for about 10 days. She denies any injury, fever, redness, or other complaints. Pain does not involve her ankle and is minimal at rest but moderate to severe with walking.

Vital signs are normal. A physical exam is also normal except for tenderness to the 5th metatarsal base. There is no appreciable swelling or warmth and pulses are symmetric.

Our latest endocrine case report from Brady Pregerson, MD, features a person in their mid-70s with a history of obesity, hypertension, osteoporosis, and prior ankle surgery presenting to urgent care with right lateral foot pain ongoing for about 10 days. Can you determine the correct diagnosis?

Endocrine Case Report: Foot Pain

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

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?