Practice Management
A 35-year-old male presents with progressive pain in his ankle. He reports a history of a gunshot to the foot without any aftercare. Review the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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The patient is a 20-year-old female who presents complaining of 1 day of generalized weakness and vomiting. She has a history of alcohol abuse and denies chest pain, shortness of breath, lower extremity swelling, fevers, chills, or any infectious symptoms. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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A 33-year-old female presents with painful “lumps” on her legs that developed over the past few days. She decided to seek care when some of them began to drain pus. She had no trauma and feels well. Her past medical history is significant for type 2 diabetes mellitus. On examination she is afebrile, with scattered tender nodules, some with purulent drainage, on the legs. View the image taken and consider what your diagnosis and next …
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As noted in this month’s cover article (Human Trafficking in the Urgent Care Setting: Recognizing and Referring Vulnerable Patients), isolation is one of many tools perpetrators use to control victims of human trafficking. Certainly this includes limiting access to healthcare. Not surprisingly, when care is necessary it’s not likely to be sought in a primary care office. Rather, busy acute care sites that offer walk-in access and relative anonymity tend to be preferred—with urgent care …
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Urgent message: As it is common for human trafficking victims to present to urgent care, providers should be able to understand and identify common red flags in the patient presentation, history, and physical exam; treat immediate medical concerns; and know how to refer and safely provide resources for suspected cases. Preeti Panda, MD Citation: Panda P. Human trafficking in the urgent care setting: recognizing and referring vulnerable patients. J Urgent Care Med. 2023;17(6):13-22. Key words: …
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Joshua Russell, MD, MSc, FCUCM, FACEP Key words: paraneoplastic syndrome, gastric cancer, seborrheic keratosis, case report ABSTRACT Introduction: Lesar-Trélat sign (LTS) is an infrequent paraneoplastic phenomenon associated with an array of malignancies. Given that the primary manifestation is a seemingly benign dermatologic issue, such patients may choose urgent care as their initial site of clinical evaluation. Clinical presentation: A 43-year-old man with no significant past medical history presented to UC with complaints of itching and …
Read MoreIvan Koay MBChB, MRCS, FRNZCUC, MD Are Urine Dipsticks Accurate in Diagnosing UTIs in Infants? Take-home point: Point-of-care (POC) urinalysis (ie, urine dipstick) is moderately sensitive and highly specific for diagnosing urinary tract infection in febrile infants. The optimum cut-point for excluding UTI is leucocytes (1+), and the optimum cut-point for confirming UTI is nitrites (trace). Citation: Waterfield T, Foster S, Platt R, et al. Diagnostic test accuracy of dipstick urinalysis for diagnosing urinary tract …
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Urgent message: Cervical necrotizing fasciitis and necrotizing mediastinitis may ultimately occur in patients presenting with symptoms of odontogenic infection. While severe illnesses rarely present in urgent care, it is important to establish a prompt diagnosis and implement rapid medical management for these patients, in order to improve survival. Vitoria Regina Nunes Maia, MS and Lindsey E. Fish, MD ABSTRACT Cervical necrotizing fasciitis (CNF) is a rapidly progressive infection that can be fatal. This condition can …
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I had time to see one more patient as my shift was winding down. “Wound check. That should be a quick one,” I said to myself. Famous last words. I soon learned that the young woman with the dog bite on her hand was returning for her fourth visit in as many days for the same issue. She sat fidgeting on the exam table and was visibly irritated when I walked in the room. “It’s …
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Monte Sandler Insurance plans are scrutinizing claims more than ever before. Common questions from our clients are: What does this mean? What should I do? Should I be worried? Generally, there are three types of payer reviews: prepayment, postpayment, and probe. The first step is to figure out what type of review it is. What you do and how you handle the review is dependent on that information. Should you be concerned? Always. Payer reviews …
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