46-Year-Old Woman With Type 2 Diabetes Mellitus and ObesityA 46-year-old woman presented to her internist for evaluation of type 2 diabetes mellitus (T2DM) and obesity.
38-Year-Old Woman With Chest PainA 38-year-old woman presented to the emergency department (ED) with abrupt onset left-sided chest pain. She described the pain as intense, sharp, and radiating to her left arm, with associated nausea and diaphoresis. Her medical history was notable for fibromuscular dysplasia of the renal arteries complicated by renovascular hypertension status post angioplasty, posttraumatic stress disorder, and former tobacco use. Her daily home medications included aspirin, hydroxyzine, lisinopril, sertraline, and trazodone.
49-Year-Old Man With Fever, Night Sweats, Palpitations, and Shortness of BreathA 49-year-old man presented to the clinic reporting fever, night sweats, palpitations, and shortness of breath. He had been experiencing symptoms for the past 6 weeks, starting with severe fatigue after a usual 7-mile run, followed by 2 weeks of intermittent fever and 4 weeks of dry cough and night sweats. During this time, he experienced 10-lb weight loss and physical activity was limited by shortness of breath; he was also experiencing intermittent palpitations. At baseline he was able to run up to 15 miles, but experienced substantial loss of exercise tolerance and was no longer able to sustain prolonged running.
82-Year-Old Man With Chest Pain and Shortness of BreathAn 82-year-old man presented to the emergency department with chest pain. His pain started one day before admission; it was intermittent, substernal, and pressure-like in nature. Gradually, the pain progressed and became constant. In addition, the patient developed shortness of breath and lower-extremity swelling.
81-Year-Old Man With Episodic Spells of Weakness, Fatigue, and “Shakes”An 81-year-old Mediterranean man presented to the emergency department with 6 months of episodic nervousness, warmth, sweating, and hunger that would subsequently progress to weakness, fatigue, difficulty concentrating, and “feeling shaky.” He denied loss of consciousness, dizziness, palpitations, chest pain, dyspnea, and post-event weakness. Symptoms occurred throughout the day and night and resolved by consuming snacks or juice. The patient thus consumed frequent scheduled meals throughout the day and night.