Practice Management
The patient is a 22-year-old male who presents for a pre-employment physical. During the exam, he mentions foot pain of several years’ duration, the origin of which he has no explanation. 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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KEY QUESTIONS What features differentiate acute pericarditis from ST-elevation myocardial infarction? What are the criteria for diagnosing acute pericarditis? What are the treatment options?
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KEY QUESTIONS What phenomenon explains the ST elevations in this ECG? What are the features of this condition? What is the clinical significance of this phenomenon?
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The patient is a 27-year-old man who complains of severe ankle pain and immobility after stumbling while on a hike. He fell approximately 1 foot onto a rock, landing with his foot in a forced flexion position. View the image taken and consider your next steps, along with possible diagnoses.
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KEY QUESTIONS What diagnosis explains the widened QRS? What are the electrocardiographic criteria for making this diagnosis? What rule(s) can help diagnose acute myocardial infarction with an ECG like this?
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The patient is a 14-year-old boy who reports to urgent care with left shoulder pain after a junior high wrestling match. He is vague about the precise location and possible mechanism of injury but through the physical exam you notice a prominence of the sternoclavicular joint and pain radiating along the clavicle. View the x-ray taken and consider what your diagnosis and next steps would be.
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The patient is a 49-year-old male who presents with a primary complaint of what he describes as “gas pain” for the past 3 days. He denies any other symptoms or suspected etiologies. View the images 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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The patient is a 23-year-old male who presents with a primary complaint of pain in his left wrist after falling from his mountain bike on a rocky path. View the x-ray 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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The patient is a 10-year-old boy who presents after twisting his right knee while playing a backyard game of badminton. The pain is such that he is unable to bear weight on the leg. 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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The patient is a 27-year-old male who presents to your urgent care center with left wrist pain after falling from his dirt bike. 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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