RESIDENTS CASE PRESENTATION

RESIDENTS CASE PRESENTATION

I. Severe Hypophosphatemia and Hypocalcemia Following Intravenous Ferric Derisomaltose and Denosumab Administration

Justin Kritzinger, MD

Internal Medicine Resident (PGY2)

McGill University

Educational Objectives:

1. Calcium and phosphorus homeostasis is tightly regulated via several hormones including PTH, FGF23, and 1,25D
2. iFGF23 levels increase following FCM (and possibly repetitive FDM) administration, resulting in increased renal phosphate excretion and decreased 1,25D production
3. Severe hypophosphatemia and hypocalcemia with the use of FDM and denosumab, respectively are rare
4. Synergistic effects likely exist with concomitant administration that can result in severe electrolyte imbalances
5. Routine monitoring and occasional temporary replacement can mitigate the clinical consequences of hypocalcemia and hypophosphatemia

II. Massively Destructive S. Anginosus Endocarditis of a Bicuspid Aortic Valve

Adriano Petrangelo, MD

Internal Medicine Resident (PGY3)

McGill University

Educational Objectives:

1. Recognize the varied presentations of infective endocarditis
2. Identify the possible complications of infective endocarditis
3. Understand predisposing conditions to developing infective endocarditis

III. Crisis in the Cortex

Hajare Iraqi, MD

Internal Medicine Resident (PGY2)

McGill University

Educational Objectives:

1. Recognize the clinical presentation of bilateral adrenal hemorrhage.
2. Identify atypical sites of bleeding complications with direct-acting oral anticoagulants.

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