Practice Management
A 12-year-old girl presents to an urgent care center with pain in her right forearm. She reports that the pain started the previous evening when she tripped on a toy left out by her 2-year-old brother. The pain is worse with range of motion. She says she does not have any numbness. She has no other injuries. View the image taken (Figure 1) and consider what your diagnosis would be.
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An 8-year-old previously healthy boy with no history of skin disease presents with painful defecation and blood-streaked stools. He says that the perianal area does not itch. Physical examination findings are significant for well-defined perianal erythema and an anal fissure. View the image taken (Figure 1) and consider what your diagnosis would be.
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A 29-year-old contact lens wearer presents to the urgent care center with a red eye, eye pain, and visual loss that has been increasing over the past 12 hours. Examination shows an injected conjunctiva with ciliary flush, and a cornea with white infiltrate in the stroma. View the image taken (Figure 1) and consider what your diagnosis would be.
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An 18-year-old young woman without a significant past medical history presents after 4 days of a cough productive of yellow sputum. Her mother states that her daughter has felt warm to the touch, but she has not checked her temperature with a thermometer. View the radiograph obtained (Figure 1) and consider what your diagnosis would be.
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A 40-year-old man presents to an urgent care center with an acutely painful red eye in which he has blurred vision. He notices a bit of a headache and that there are some halos around lights, but he says that he has not experienced nausea or vomiting. When reviewing his medical history with you, he notes that he recently started taking a new antidepressant. View the image taken (Figure 1) and consider what your diagnosis …
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A 70-year-old man presents with blurred vision and a nasal-field defect in one of his eyes. He reports that before arriving in the emergency department, he saw flashes of light and floaters, accompanied by a shower of black dots blocking his vision. Figure 1 shows what the physician sees when examining the patient’s eye with indirect ophthalmoscopy and scleral depression. Consider what your diagnosis would be.
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An 80-year-old man reports waking up with a localized area of erythema on his forehead. He says that he did not worry about it until the lesion slowly became white and then started turning blue over a few hours. He says that the lesion is painful and is getting larger and darker. He reports no headaches, muscle pain, abdominal pain, sweating, or tremors. View the image taken (Figure 1) and consider what your diagnosis would …
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A healthy, full-term baby girl was born to a healthy mother who had adequate prenatal care and no signs of infectious diseases. Three days after birth, the baby developed multiple 1-mm pale-yellow to yellow pustules within a large inflammatory wheal on her cheek. Several hours later, the rash starts to resolve. View the image taken (Figure 1) and consider what your diagnosis would be.
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A 30-year-old woman presents with a red eye, associated with eye pain, light sensitivity, and slightly decreased vision, which started 4 days earlier. She was previously treated with tobramycin, but she has not noticed any change in the condition of her eye. Examination shows an injected conjunctiva and a hypopyon. On further examination with a slit lamp, inflammatory cells are evident in the anterior chamber. View the image taken (Figure 1) and consider what your …
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A 35-year-old woman presents with a history of 1 day of pain in her right eye, photophobia, and decreased vision. There is no history of trauma. One day earlier, she was seen at an urgent care center, where the diagnosis was a corneal abrasion, and she was treated with topical trimethoprim-polymyxin. Her symptoms have worsened, so she has returned for further evaluation. View the image taken (Figure 1) and consider what your diagnosis would be.
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