Practice Management
A 62-year-old woman presents to an urgent care center with severe left hip pain that began several hours earlier after a motor vehicle accident. She was the driver, and she was wearing a seat belt. Her car’s driver-side air bag deployed when her car, moving at about 35 miles per hour, rear-ended a stopped car. She refused to be transported from the accident scene by emergency medical services for treatment because her only issue was …
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A 35-year-old man with a history of human immunodeficiency virus presents with smooth, skin-colored pearly papules with central umbilication on his cheeks, chin, and lateral neck. View the image taken (Figure 1) and consider what your diagnosis would be.
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A 32-year-old man presents to an urgent care center with pain at the metacarpophalangeal (MCP) joint of the thumb, from an injury sustained the previous week when he was skiing and fell onto his hand with his thumb extended. The patient has pain at the MCP joint with range of motion, but he says that he does not have any numbness. He has no fever, no breaks in the skin, no wrist pain, and no …
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A 67-year-old man presents with constipation that has been present for the preceding 2 days. He reports that he has had constipation in the past that resolved with the use of over-the-counter stool softeners, but this therapy has not worked with this episode. He has generalized abdominal pain that was mild initially but increased over the preceding day, which prompted his visit to the urgent care center. He describes the character of the pain as …
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A 37-year-old woman without a significant past medical history presents after 3 days of a cough that produces yellow sputum with some streaks of blood. She has not checked her temperature but says she has “felt warm” and has some chills. She does have associated shortness of breath, but she reports that she has not had chest pain, leg pain or swelling, sweating, or headache. She has a history of hypertension, and she takes an …
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A 38-year-old man presents to an urgent care center after falling from a ladder the same morning. He has pain in his right foot at the midaspect that is worse with movement through the range of motion. There is minimal associated numbness. There is no ankle pain, knee pain, fever, or vomiting. View the image taken (Figure 1) and consider what your diagnosis would be.
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An 18-year-old high school lacrosse player presents to an urgent care center with a painful left ankle. He states that the pain started 2 days earlier when he twisted his left ankle (an inversion injury) while competing in a tournament. He says that he tried to continue to play, but the pain increased. He reports that the ankle swelled over the lateral aspect and that he has pain when he walks. He says that he …
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A 33-year-old man presents to the urgent care 2 hours after hitting his middle finger of his left hand with a hammer. He has severe pain and has wrapped the finger in bacon. His pain increases as he moves through the range of motion, and he has numbness over the tip of the finger. He has no other injuries, and his tetanus immunization is up to date. View the image taken (Figure 1) and consider …
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A 37-year-old man presents to an urgent care center after 2 days of fever and sore throat. He reports that the soreness is worse with swallowing. He reports that he did not have any preceding rhinorrhea or myalgias. He has had no exposure to ill persons, and he has no history of previous illnesses. He reports that he smokes cigarettes and occasionally drinks alcohol. View the image taken (Figure 1) and consider what your diagnosis …
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A 51-year-old man presents to an urgent care center with sharp left thoracic pain that began suddenly after he fell after tripping on a banana peel that had been left on his kitchen floor. He has pain with breathing as well as with range of motion of the chest wall. He reports no head trauma, head or neck pain, fever, vomiting, or dizziness. View the image taken (Figure 1) and consider what your diagnosis would …
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