Challenge your diagnostic acumen: Study the following x-ray images, electrocardiograms, and photographs and consider what your diagnosis might be in each case. While the images presented here are authentic, the patient cases are hypothetical.

Lower Lobe Cystic Bronchiectasis

60-Year-Old With Annoying Cough

A 60-year-old man presents to urgent care complaining of an annoying cough for several months. He states that he frequently has sputum production with his cough. He denies any fever, chills, or other symptoms. Review the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page …
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Brugada syndrome

15-Year-Old Gasping for Air

A 15-year-old male with no significant past medical history presents after he was noted to be gasping for air and difficult to arouse after taking a nap. At the urgent care, an ECG is obtained. View the ECG captured above and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. Figure 1. Initial EKG Case presented by Erik Alvarado, MD, McGovern Medical School at the University of Texas Health Science Center at Houston …
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Hogweed Dermatitis

29-Year-Old With Stinging Sensation

A 29-year-old woman presents to urgent care for a painful rash that developed on her arm.  It started 1 day after working on a landscaping project that involved pulling weeds under intense sunlight. On examination, an edematous, pink, scaly plaque and nearby erosions are seen on her right arm. The patient appears well and has no systemic symptoms. View the image below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. Figure 1 …
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Foot Pain After Hiking

48-Year-Old With Foot Pain After Hiking

A 48-year-old man presents to urgent care complaining of pain in his right foot after hiking last weekend on a rough trail. He denies any trauma or specific injury. Review the images below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page …
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42-Year-Old With Stinging Sensation

42-Year-Old With Stinging Sensation

A 42-year-old woman presented to urgent care early in the morning saying that she felt a stinging sensation on her arm while she was cleaning her basement the previous day. She thinks it might be a bite but didn’t see anything. She had subsequent marked pain at the site and over the past few hours developed nausea and muscle aches. On physical examination, the patient had a temperature of 101.3°F (38.5°C). There were reddish-brown reticulate patches with intervening pallor and a rim of erythema on the posterior arm. View the …
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