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.
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A 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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A 22-Year-Old Man with an Itchy Patch of Skin
A 22-year-old man presents to urgent care with a round, hyperpigmented patch on his arm. He reports that it’s “itchy,” and that it appeared soon after taking a second dose of a sulfonamide he’s taking for a persistent sinus infection. View the photo and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreAn 82-Year-Old Man with Palpitations
An 82-year-old man presents with complaints of palpitations. He denies chest pain, shortness of breath, dizziness, fever, vomiting, or confusion. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, or guarding 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 42-Year-Old Man with Thumb Pain After a Fall
A 42-year-old man arrived at your urgent care center complaining of thumb pain a day after taking a fall while skiing. You find that the pain is worse with movement in any direction; in addition, he exhibits limited ability to grip anything using his thumb. 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. <1–nextpage–> Differential Diagnosis Avulsion …
Read MoreClinical Challenge 2: April 2016
Case A 42-year-old woman presents with pain in her right shoulder that suddenly began after she caught herself with her raised right arm as she fell. She reports that she had been standing on a step stool and reaching for an object, and then fell forward. She has severe pain in the right shoulder, and it worsens with movement even through a minimal range of motion. She has associated numbness over the lateral portion of …
Read MoreA 48-Year-Old Female with Pruritic Lesions
Case A 48-year-old woman presents with several red lesions that are extremely pruritic. They are scattered haphazardly on the back of her leg. A few of the lesions are still smooth nodules, but others are now excoriations; she just can’t stop scratching them no matter how hard she tries. She estimates they appeared nearly a month ago. She reports a history of atopic dermatitis, but “this doesn’t feel like the same thing.” View the photo …
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A 26-Year-Old Man with Palpitations
The patient is a 26-year-old man who presents after 3 days of palpitations. He denies any chest pain, shortness of breath, diaphoresis, fever, or dizziness. He does use home oxygen (2 L/min), but denies any new shortness of breath. Upon exam, you find: General: Alert and oriented X 3 Lungs: Clear to auscultation bilaterally Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, or guarding Extremities: No pain …
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A 9-Year-Old Boy with Pain After Twisting His Knee
The patient is a 9-year-old boy who was brought in by his parents with right knee pain. He reports that he twisted it while reenacting Star Wars battles in the backyard with friends. His parents did not witness the injury. 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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