A 38-Year-Old Female with Abdominal Pain and Chest Tightness

A 38-Year-Old Female with Abdominal Pain and Chest Tightness

A 38-year-old female with no past medical history presents to an urgent care with right upper quadrant abdominal pain and chest tightness, worsening for 1 week. She reports that her chest tightness is associated with shortness of breath, and is worse when walking and lying on her side. She denies fever, cough, dysuria, headache, or weakness. View the ECG and consider what your diagnosis and next steps would be. (Case presented by Catherine Reynolds, MD, …

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A 24-Year-Old Man with Ankle Pain After a Fall

A 24-Year-Old Man with Ankle Pain After a Fall

The patient is a 24-year-old male who reports to urgent care with right ankle pain after falling from a ladder while cleaning out the gutters at his parents’ home. He reports that he was only a few rungs up but that he landed “awkwardly” and immediately felt a sharp pain on the front of the ankle. He is unable to bear weight but denies any numbness or tingling. View the x-ray taken and consider what …

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A 36-Year-Old Man with Wrist Pain After a Traumatic Impact

A 36-Year-Old Man with Wrist Pain After a Traumatic Impact

The patient is a 36-year-old man who presents with wrist pain after “hitting it on something.” Further history reveals that he punched a wall in a fit of anger and felt sharp pain immediately.  He has no past medical history and takes no medications. 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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A 46-Year-Old Woman with a Painful, Erythematous Plaque on Her Leg

A 46-Year-Old Woman with a Painful, Erythematous Plaque on Her Leg

The patient is a 46-year-old female who presents with a painful, erythematous, indurated plaque on her lower leg. She reports that it developed over the past month. At first she attributed the pain to “a bump” of unknown origin, but as the area of red skin expanded she became concerned that she became concerned, as she reports a history of deep-vein thrombosis.               View the image taken and consider what your diagnosis and next steps …

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A 34-Year-Old Female with a Syncopal Episode but No Remarkable History

A 34-Year-Old Female with a Syncopal Episode but No Remarkable History

A 34-year-old female with no reported medical history presents to urgent care after a syncopal episode. She describes standing up rapidly to answer the phone, followed by a sensation of lightheadedness and nausea with subsequent collapse. On evaluation, her vital signs are normal, she appears well, and she is currently asymptomatic. View the ECG taken and consider what your diagnosis and next steps would be. (Case presented by Tom Fadial, MD, The University of Texas …

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A 96-Year-Old Male with Palpitations and a History of CAD

A 96-Year-Old Male with Palpitations and a History of CAD

The patient is a 96-year-old man who is brought to your urgent care center by his daughter, with whom he lives. She reports that he has been feeling light-headed for “a few days.” The patient confirms this, adding that he has felt his heart “fluttering,” as well. He denies chest pain and shortness of breath, but acknowledges a history of coronary artery disease. View the ECG and consider what your diagnosis and next steps would …

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A 13-Year-Old Girl with Scaling and Fissures on Her Lips

A 13-Year-Old Girl with Scaling and Fissures on Her Lips

The patients is a 13-year-old girl who presents to a pediatric urgent care clinic with 1 month of scaling and fissures on her lips which began after she started using a retinoid cream prescribed for acne.             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 71-Year-Old Woman with Femur Pain After a Fall

A 71-Year-Old Woman with Femur Pain After a Fall

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.

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A 7-Year-Old Girl with White Patches on Her Toenails

A 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.

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