COVID-19-Associated Nephropathy: A Devastating Complication.

With the rapid emergence and prevalence of SARS-CoV-2 worldwide, cases of COVID-19-associated nephropathy (COVAN) from collapsing focal segmental glomerulosclerosis (cFSGS) have been reported, and the associations between the two are actively being studied. Creating appropriate treatment guidelines for COVAN requires further understanding of the pathophysiology of this type of kidney injury. This case report outlines the case of a 77-year-old patient admitted to the hospital for COVID-19 infection with a subsequent renal biopsy indicating cFSGS, adding to the data exploring the relationship between COVID-19 infections, cFSGS and the associated risk factors.

Varicella Zoster Meningitis in a Young, Immunocompetent Patient Despite Initiation of Antiviral Therapy.

Varicella zoster virus (VZV) reactivation, also known as herpes zoster is common in older adults and immunocompromised individuals and often causes a painful, vesicular rash limited to a dermatomal distribution. On occasion, it can lead to various neurological complications as well. Here we present the case of a young, immunocompetent male in his 20's with a history of primary varicella infection who presented with complaints of a painful rash in the S3-S4 dermatomal distribution.

A Case of Adult-Onset Still's Disease with Positive Antinuclear Antibodies.

Adult-onset Still's disease (AOSD) is a rare inflammatory disorder involving multiple systems. It can present a wide range of symptoms like maculopapular rash, fever, and arthralgia, which may overlap with many other disorders, making it difficult to diagnose. Unknown etiology and no diagnostic tests further make it complex to establish the diagnosis of AOSD.

A case report of double negative anti-GBM disease.

Goodpasture's disease is a life-threatening autoimmune disease that can lead to end stage renal disease and death. We report a case of 61-year-old female who presented with deteriorating renal function. Initial laboratory investigations were negative for autoimmune antibodies including negative anti-neutrophilic cytoplasm antibodies and anti-glomerular basement membrane (anti-GBM) antibodies using both enzyme-linked immunosorbent assay and indirect immunofluorescence.

Merkel cell carcinoma with intramedullary spinal cord metastasis: a very rare clinical finding.

This clinical image teaches readers that a rare finding such as intramedullary spinal metastasis could exist even in the rarest tumors. It adds to the literature how it was managed. It also might reflect the improvement of our cancer treatment allowing us to follow patients longer to find those rare findings in rare tumors.

Nodular pulmonary amyloidosis with primary pulmonary MALT lymphoma masquerading as metastatic lung disease.

Nodular pulmonary amyloidosis is a very rare form of localized amyloidosis involving the lung, with very little known about its nature. It is usually associated with indolent B cell lymphoproliferative disorder and also connective tissue disorders. No definite treatment guideline exists.

A case of nausea and vomiting to remember.

Nausea and vomiting are the most common overlooked debilitating symptoms that significantly impact the quality of life and acute care we provide as physicians. The duo has an extensive aetiology ranging from common known causes to uncommon idiopathic reasons. Our case illustrates the fact that identifying the aetiology of nausea and vomiting can be lifesaving, given the characteristics of the patient.

Dystextia as a presentation of stroke.

Cerebrovascular accident remains one of the major causes of morbidity and mortality worldwide. Understanding the presentation of this common disease will be of great benefit for early diagnosis and management. We report a newly recognised symptom of stroke where there is difficulty writing mobile phone texts, an entity called dystextia.

Resolution of neurological deficits secondary to spontaneous intracranial haemorrhage and posterior reversible encephalopathy syndrome (PRES) in a patient with hepatitis C-associated cryoglobulinaemia: a role for plasmapheresis.

Essential mixed cryoglobulinaemia or type II cryoglobulinaemia is an important extrahepatic manifestation of chronic hepatitis C. Cryoglobulinaemia results in the deposition of immune complexes in small or medium-sized blood vessels leading to palpable purpura, arthralgia, renal disease and peripheral neuropathy. Posterior reversible encephalopathy syndrome (PRES) is a distinct phenomenon characterised by vasogenic oedema in the posterior circulation of brain.

Are students ready for meaningful use?

Background: The meaningful use (MU) of electronic medical records (EMRs) is being implemented in three stages. Key objectives of stage one include electronic analysis of data entered into structured fields, using decision-support tools (e.g.

Mobile technology for the facilitation of direct observation and assessment of student performance.

Background: We developed, implemented, and assessed a web-based clinical evaluation application (i.e., CEX app) for Internet-enabled mobile devices, including mobile phones.

Sweet's syndrome as a dermatological manifestation of underlying coronary artery disease.

We report an unusual case of a 50-year-old female with no significant past medical history who reported with a sudden eruption of painful erythematous papules accompanied by fever. Clinical and pathological findings were consistent with acute febrile neutrophilic dermatosis (or Sweet's syndrome). Two weeks later, she complained of chest pain and was diagnosed with non-ST elevation myocardial infarction.

The implementation of a mobile problem-specific electronic CEX for assessing directly observed student-patient encounters.

Background: Facilitating direct observation of medical students' clinical competencies is a pressing need.

Methods: We developed an electronic problem-specific Clinical Evaluation Exercise (eCEX) based on a national curriculum. We assessed its feasibility in monitoring and recording students' competencies and the impact of a grading incentive on the frequency of direct observations in an internal medicine clerkship.