The patient is a 71-year-old female who presents with proximal femur pain after losing her balance and sustaining a “soft” fall onto a carpeted surface. She has a past history of hypertension, hypercholesterolemia, and osteoporosis. She takes a statin, an ACE inhibitor, and a bisphosphonate. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 7-Year-Old Girl with White Patches on Her Toenails
Case A mother brought her 7-year-old daughter to the pediatric urgent care center after noticing that several of the girl’s toenails on each foot had white patches and appeared short and broken. They seemed to be lifting off the nail beds and looked thinner than usual. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 60-Year-Old Woman with Hypertension, Diabetes, and Sudden Fatigue and Weakness
A 60-year-old female with a history of hypertension and diabetes presents to urgent care with fatigue and weakness for 1 day. Her son states she has not been able to get out of bed today because she’s “too tired to walk.” She denies any complaints of chest pain, nausea, vomiting, shortness of breath, or fever. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described …
Read MoreA 32-Year-Old Male with Thumb Pain After a Ski Fall
The patients is a 32-year-old man who presents with pain in his left thumb after skiing. He reports that he took a fall, instinctively extending his left arm out to cushion the blow. View the thumb x-ray taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreA 35-Year-Old Man with Chest Pain
The patient is a 35-year-old male who presents with chest pain, which he reports started after he was hit in the chest with an errant pass during his son’s basketball practice. 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. Figure 1.
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 …
Read MoreA 38-Year-Old Woman with Shoulder Pain
Case A 38-year-old female patient presents with acute shoulder pain following a fall on an outstretched arm during a spring skiing vacation. There is a normal appearance to the shoulder, but significant pain even with minimal attempts at range of motion. The clavicle and elbow are nontender. Neurovascular status is intact. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described on the …
Read MoreA 62-Year-Old Woman with Dizziness and Palpitations
Case The patient is a 62-year-old woman who presents to the urgent care center after 1 hour of intermittent dizziness and feeling of palpitations. She has no chest pain, fever, vomiting, or diarrhea. Further history reveals that she has a history of anxiety, which is manifested by intermittent feeling of heart “palpitations.” Her primary care doctor is treating her with a selective serotonin reuptake inhibitor (SSRI) for anxiety. Upon exam, you find: General: Alert and …
Read MoreDull, Constant Back Pain After a Fall: Abdominal Aortic Aneurysm (AAA)
Case A 67-year-old male presents with acute mid-low back pain following a fall. He describes the pain as “dull and constant.” When asked if the pain is worse with range of motion, he replies, “I think so.” Physical exam reveals he is afebrile, has a pulse of 102, respirations 20, and blood pressure 122/78. His abdomen is soft and nontender without rigidity, rebound, or guarding; there is no bruising or distention. His back appears normal, …
Read MoreClavicular Pain in a 23-Year-Old
Case A 23-year-old man presents to an urgent care with pain at the distal end of his left clavicle that began the previous day after he fell onto his left shoulder while mountain biking. His pain is constant and sharp and worse when moving his left arm and shoulder. He does not have fever, vomiting, chest pain, shortness of breath, or abdominal pain, and he has no head injury, no head or neck pain, and …
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