The patient is a 24-year-old male who reports to urgent care with right ankle pain after falling from a ladder while cleaning out the gutters at his parents’ home. He reports that he was only a few rungs up but that he landed “awkwardly” and immediately felt a sharp pain on the front of the ankle. He is unable to bear weight but denies any numbness or tingling. View the x-ray taken and consider what …
Read MoreA Patient on Dialysis with Syncope
History: A 67-year-old female presents to urgent care complaining of one episode of syncope earlier in the day. No seizure-like activity was noted by the family and she returned to baseline within a minute. She has a past medical history of end-stage renal disease on scheduled hemodialysis, hypertension, diabetes, coronary artery disease, and chronic nausea. Medications include aspirin, insulin, amlodipine, hydralazine, ondansetron, metoclopramide, and amiodarone. View the ECG taken and consider what your diagnosis …
Read MoreA 36-Year-Old Man with Wrist Pain After a Traumatic Impact
The patient is a 36-year-old man who presents with wrist pain after “hitting it on something.” Further history reveals that he punched a wall in a fit of anger and felt sharp pain immediately. He has no past medical history and takes no medications. View the images taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 46-Year-Old Woman with a Painful, Erythematous Plaque on Her Leg
The patient is a 46-year-old female who presents with a painful, erythematous, indurated plaque on her lower leg. She reports that it developed over the past month. At first she attributed the pain to “a bump” of unknown origin, but as the area of red skin expanded she became concerned that she became concerned, as she reports a history of deep-vein thrombosis. View the image taken and consider what your diagnosis and next steps …
Read MoreA 34-Year-Old Female with a Syncopal Episode but No Remarkable History
A 34-year-old female with no reported medical history presents to urgent care after a syncopal episode. She describes standing up rapidly to answer the phone, followed by a sensation of lightheadedness and nausea with subsequent collapse. On evaluation, her vital signs are normal, she appears well, and she is currently asymptomatic. View the ECG taken and consider what your diagnosis and next steps would be. (Case presented by Tom Fadial, MD, The University of Texas …
Read MoreA 13-Year-Old Boy with Knee Pain After a Fall
The patient is a 13-year-old boy who presents with knee pain after an awkward fall while playing basketball on an asphalt court. He is unable to walk due to pain and has a swollen knee. View the x-rays taken and consider what your diagnosis and next steps would be.
Read MoreA 96-Year-Old Male with Palpitations and a History of CAD
The patient is a 96-year-old man who is brought to your urgent care center by his daughter, with whom he lives. She reports that he has been feeling light-headed for “a few days.” The patient confirms this, adding that he has felt his heart “fluttering,” as well. He denies chest pain and shortness of breath, but acknowledges a history of coronary artery disease. View the ECG and consider what your diagnosis and next steps would …
Read MoreA 13-Year-Old Girl with Scaling and Fissures on Her Lips
The patients is a 13-year-old girl who presents to a pediatric urgent care clinic with 1 month of scaling and fissures on her lips which began after she started using a retinoid cream prescribed for acne. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 71-Year-Old Woman with Femur Pain After a Fall
The patient is a 71-year-old female who presents with proximal femur pain after losing her balance and sustaining a “soft” fall onto a carpeted surface. She has a past history of hypertension, hypercholesterolemia, and osteoporosis. She takes a statin, an ACE inhibitor, and a bisphosphonate. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 7-Year-Old Girl with White Patches on Her Toenails
Case A mother brought her 7-year-old daughter to the pediatric urgent care center after noticing that several of the girl’s toenails on each foot had white patches and appeared short and broken. They seemed to be lifting off the nail beds and looked thinner than usual. View 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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