A 4-Week-Old Girl with a New Rash on Her Back

A 4-Week-Old Girl with a New Rash on Her Back

A mother brought her 4-week-old daughter to the doctor concerned about a vesicular rash that developed on the girl’s back within the last day. On examination, tiny vesicles in a primarily truncal distribution were seen. The patient had no systemic symptoms and appeared well. 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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An 87-Year-Old Male with Chest Pain, SOB, and a History of Valvular AFib, Stroke, and Heart Failure

An 87-Year-Old Male with Chest Pain, SOB, and a History of Valvular AFib, Stroke, and Heart Failure

An 87-year-old male with past medical history of valvular atrial fibrillation, prior stroke, and heart failure presents to urgent care with chest pain and shortness of breath for 3 days. The pain and difficulty breathing are associated with bilateral lower extremity swelling for 1 week.               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 43-Year-Old Woman with a New Ulcer on One Hand

A 43-Year-Old Woman with a New Ulcer on One Hand

A 43-year-old woman presents with 2 weeks of a smooth nodule on her right hand. The patient denies recent travel but recalls that she “banged up” her hand while cleaning out a fresh-water fish tank prior to noticing the nodule. Past medical history is significant for renal transplantation. Exam reveals a tender, erythematous plaque with an ulcer on dorsal aspect of her hand.               View the image and consider what your diagnosis and next steps …

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39-year-old Male with Sharp, Nonradiating Chest Pain

39-year-old Male with Sharp, Nonradiating Chest Pain

History: A 39-year-old male with no known past medical history presents to urgent care for evaluation of several hours of sharp, non-radiating, left-sided chest pain. The pain is non-exertional, non-pleuritic, began after his last meal and resolved without intervention approximately 30 minutes prior to arrival. No history of similar pain in the past. No associated shortness of breath, nausea, vomiting, or diaphoresis. View the ECG taken and consider what your diagnosis and next steps would …

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A 55-Year-Old with a Recent History of Rash

A 55-Year-Old with a Recent History of Rash

A 55-year-old female presents to urgent care with a few weeks of a mildly pruritic rash on her trunk and arms. On examination, there are scattered erythematous, fine, scaly plaques. The coin-like plaques are round or oval in configuration and affect her extremities symmetrically. The patient denies current medications or any personal or family history of dermatologic conditions. She reports no systemic symptoms. However, she shares that she has been taking longer and more frequent …

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An 18-Year-Old with Diffuse Abdominal Pain

An 18-Year-Old with Diffuse Abdominal Pain

An 18-year-old male presents to urgent care with widespread abdominal “gas pain” for several days. He denies changes in diet or changes in bowel habits. However, he recalls having a hard collision with another player during a lacrosse game prior to onset of symptoms. 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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A 10-Year-Old with Fever, Headache, Muscle Aches, Nausea—and a Suspicious Rash

A 10-Year-Old with Fever, Headache, Muscle Aches, Nausea—and a Suspicious Rash

The patient is a 10-year-old girl who presents to urgent care with 3 days of fever, headache, muscle aches, nausea, and a skin rash. She has a temperature of 102°F. On examination you find numerous erythematous macules and purpura on her palms and the soles of her feet. The patient is immunocompetent with an unremarkable medical history. Her mother recounts no recent travel from their home in North Carolina, but notes that the patient spent …

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A 35-Year-Old with a Persistent, Frequent Cough

A 35-Year-Old with a Persistent, Frequent Cough

The patient is a 35-year-old woman who presents with a frequent, light cough of several months’ duration. Her medical history is unremarkable, including no history of COVID-19. She is a former “social smoker” who worked out on a treadmill sporadically before the cough began.  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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