Internal medicine memorable moments

• Ascites, 18L out
• Enormous pulmonary artery aneurysm
• D-transposition of the great arteries (post Glenn and MBTS)
• Guy from WWI times
• Wellen's syndrome on EKG
• Nicest old man ever - I just want him to be my grandfather!
• Patient almost presented as CPC case - 2yr dyspnea with multiple skin abscesses 
• Answer: ANCA negative Wegener's w/o renal involvement (per me)
• Small cell lung cancer, SIADH, metastasized to brain
• Gastric adenocarcinoma with duodenal inflammation
• Doing Epley maneuver ironically induced nystagmus
• Young man with ejection fraction of 20%, ESRD, DKA glucose of 1200 (HbA1c 12.5)
• Hearing crisp, metallic S1 of bicuspid metal valves
• Hypertrophic cardiomyopathy patient: according to nurse, "He's nice, but kind of a dick. He's a nice dick. Is that possible?"  Hearing the systolic murmur increase with valsalva was a bonus.
• Severe mitral stenosis with 7cm left atrium (size of ventricles combined!)
• Hearing S3, S4, and even some diastolic rumble (above)