Case The patient is a 74-year-old man who complains of epigastric pain. He is an alcoholic who has had multiple episodes of pancreatitis. He has no chest pain, shortness of breath, or diaphoresis. An ECG is performed by staff prior to provider evaluation. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop, occasional irregular beats Abdomen: Soft and NT without r/r/g View the ECG taken and consider …
Read MoreA 51-Year-Old Woman with Wrist Pain After a Fall
Case A 51-year-old woman presents with wrist pain and swelling after tripping on a loose piece of carpeting and falling on her outstretched hand. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 42-Year-Old Man with Skin Petechia and Palpable Purpura on His Legs
The patient is a 43-year-old man who presents to urgent care with widespread skin petechia and palpable purpura on his legs. He reports these symptoms occurred around 2 weeks after he recovered from an upper respiratory tract infection. In addition, he’s experienced fever, diarrhea, and vomiting. He mentions pain in his scrotum, as well. View the photo (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described …
Read MoreA 60-Year-Old Man with a 2-Year History of Dizziness
The patient is a 60-year-old man with a 2-year history of dizziness. He denies chest pain, shortness of breath, diaphoresis, vomiting/diarrhea, or fever. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop, occasional irregular beats Abdomen: Soft and NT without r/r/g View the ECG taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. …
Read MoreA 35-Year-Old Man with Chest Pain
The patient is a 35-year-old male who presents with chest pain, which he reports started after he was hit in the chest with an errant pass during his son’s basketball practice. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. Figure 1.
Read MoreA 45-Year-Old Male with Sudden Eye Pain
A 45-year-old man presents with bilateral ocular pain, excessive tearing, and bloodshot eyes. He reports that his symptoms began 2 days ago with the sensation of a foreign body lodged in his eye, and that his eyes have been unusually sensitive to light. He has not worn his contacts since the onset of symptoms. View the photo and consider what your diagnosis and next steps would be. Resolution of the case is described on the …
Read MoreA 20-Year-Old Woman with Acute Chest Pain
The patient is a 20-year-old female who presents with sudden onset of left sided chest pain. A collegiate cross-country runner, she reports that she also felt lightheaded when lacing up her running shoes earlier in the day. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 51-Year-Old Man with Shortness of Breath and ‘Burning’ in His Chest
The patient is a 51-year-old man with shortness of breath and an intermittent burning sensation in his chest. His symptoms began 2 days ago. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT without r/r/g View the ECG and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 3-Year-Old with Lesions on His Thumb
A mother brings her 3-year-old son to urgent care with multiple skin lesions on his thumb, which he frequently sucked for comfort. The grouped configuration of lesions was painful and had developed over the last 5 days to become vesicles. Upon exam, you note that the boy has a nearly healed cold sore on his lip, pain in his wrist, and an elevated temperature. View the photo and consider what your diagnosis and next steps …
Read MoreA 21-Year-Old Male with Persistent Ankle Pain Following Trauma
The patient is a 21-year-old male who presents with persistent ankle pain 4 weeks after suffering a trauma. He fell while scaling the exterior of his dormitory, trying to gain entry into a second-floor window because he’d locked his keys inside. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
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