Atypical Chest Pain in a Fibromyalgia Patient Presenting to Urgent Care

Tracey Q. Davidoff, MD, FACP, FCUCM Urgent message: Underlying medical and psychiatric conditions can cloud judgment and lead to cognitive errors, which may result in potentially serious medical errors.1 Case Presentation A 31-year-old woman with a medical history significant for fibromyalgia, migraines, bipolar disorder, and anxiety presents with 2 hours of severe bilateral neck spasms, left shoulder and arm pain, and chest pain which began soon after taking a new prescription for olanzapine. She also …
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An 11-Year-Old Girl with Red, Itchy Rash

Urgent message: Urticaria from cold exposure should be considered to prevent future anaphylaxis and angioedema with re-exposure. KELSEY REED, MSN, APRN, FNP-C CASE PRESENTATION An 11-year-old girl presents to urgent care with complaints of repetitive episodes of sudden onset of itchy red rash with ill-defined borders which has occurred three times in the past 1.5 weeks following exposure to cold water. Twice, the hives occurred after swimming in a pool and once in a local …
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Absence of an obvious cause of symptoms should not mislead the clinician away from the likely diagnosis based on those symptoms. In this case, for example, the patient was ultimately diagnosed with a symptomatic chronic subdural hematoma associated with repetitive straining secondary to cough and constipation.

An Unusual Etiology of Chronic Subdural Hematoma: Case Report and Review of the Literature

Urgent message: Absence of an obvious cause of symptoms should not mislead the clinician away from the likely diagnosis based on those symptoms. In this case, for example, the patient was ultimately diagnosed with a symptomatic chronic subdural hematoma associated with repetitive straining secondary to cough and constipation. Joel Kaye, BS, MS4 and Dana Tarina, MD Introduction Chronis subdural hematoma (CSDH) is an encapsulated collection of old blood in the space between the arachnoid membrane …
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A 30-Year-Old Female with Headaches of Increasing Frequency

Urgent message: Cerebral venous sinus thrombosis (CVST) occurs when a blood clot forms in the venous sinuses within the brain, preventing drainage of blood. It can cause blood cells to break down and leak into the brain tissues, forming a hemorrhage. This can result in stroke. CVST affects about 5 people in 1 million per year. Aasia Ferdous, DO and Jordan Miller, DO CASE PRESENTATION A 30-year-old female presented to urgent clinic with a headache …
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Abdominal Pain in the Younger Adult: Let’s Not Forget Acute Diverticulitis

Urgent message: The differential diagnosis of abdominal pain is challenging because many symptoms and signs are nonspecific and because patients might often have concomitant medical conditions that could cause abdominal pain. Although diverticulitis is more common in older patients, failure to consider diverticulitis in the differential diagnosis of abdominal pain in the younger adult could lead to delayed diagnosis and undesirable complications. Fabrizia Faustinella, MD, PhD, FACP and L. Alexandre Frigini, MD Introduction Diverticular disease …
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