Practice Management
A 16-year-old female presents to urgent care with her mother after soccer practice at school. She says she felt a “pop” in her left hip, immediately followed by posterior hip pain. Walking makes it worse, but resting makes the pain better. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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A 74-year-old woman presents to urgent care with epistaxis, controlled on arrival. She is also complaining of lightheadedness and fatigue that’s been going on for the past 2 weeks. 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.
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A 65-year-old woman presents to urgent care complaining of a growth that developed on her finger 2 months prior. She says it’s not painful or itchy and has not grown since she first noticed it. On examination, a solitary, smooth, pinkish papule with a tiny central crust is seen on her distal interphalangeal joint on her left index finger. The patient has a history of osteoarthritis. View the image below and consider what your diagnosis …
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A 29-year-old man presents to urgent care on a Saturday with pain in his left foot after playing tennis. A series of x-rays is ordered. Review the images below and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page. Differential Diagnosis Diagnosis The correct diagnosis is an avulsion fracture of the base of the 5th metatarsal. The x-ray shows transverse lucency at the base of …
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A 27-year-old female with history of asthma presents to urgent care on a Friday morning with dyspnea for 1 day. She denies palpitations, syncope, or chest pain. 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.
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A 16-year-old girl presents to urgent care with complaints of fever, chills, and a diffuse sunburn-like rash that developed over the past day. The patient underwent septoplasty 2 days prior for a deviated septum, and nasal packing was utilized to manage her postoperative bleeding. On examination in urgent care, she was febrile to 104°F (40°C), tachycardic, and hypotensive. Widespread erythematous blanching macules and patches were seen. View the image below and consider what your …
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A 55-year-old woman presents to urgent care complaining of pain when she moves her right wrist. She reports the pain began suddenly when she woke up that morning without any known trauma. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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A 35-year-old male with a history of end-stage-renal-disease (ESRD) presents to urgent care complaining of back pain. The patient missed his dialysis session today because of the pain. An ECG is obtained. View the ECG captured below 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 15-year-old girl presents to urgent care with complaints of fever, arthralgia, abdominal pain, and a widespread rash that developed over the last 2 days. The patient says that the pain in her knees is severe and debilitating. On examination, the patient has a temperature of 100.3°F (37.9°C) as well as maroon and violaceous, purpuric papules and plaques on the legs, buttocks, and face. Laboratory examination shows elevated erythrocyte sedimentation rate and C-reactive protein, proteinuria, …
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A 30-year-old woman presents to urgent care with pain in her lower back and pelvis. She denies any injury or accident that might be causing her pain. She has just returned to full-time work after having a baby. An x-ray is ordered. Review the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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