Clinical Feature Articles

Urgent Message: As shortness of breath and edema are common in pregnancy, urgent care clinicians must distinguish patients with normal physiologic changes from those with emergent conditions like venous thromboembolism, hypertension, eclampsia, and cardiomyopathy. John Ramos, MMS, PA-C, CAQ-EM Key Words: Ambulatory Care; Differential Diagnosis; Dyspnea; Pregnancy Complications; Pregnancy Complications, Cardiovascular Abstract Background: Physiologic changes in pregnancy contribute to shortness of breath and edema. However, these symptoms can also be caused by serious etiologies including venous thromboembolism (VTE) (increased risk in pregnancy and a leading cause of maternal mortality), preeclampsia …
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Urgent Message: Patients frequently utilize urgent care centers for testing and treatment of sexually transmitted infections. All clinicians can be a first line defense to control the spread and combat the current epidemic. Alexandra Faraj, PA-S; Nadesha Muniz, MS Ed, PA-C Key Words: Sexually Transmitted Infections; Chlamydia; Gonorrhea; Syphilis; Expedited Partner Therapy; Urgent Care Abstract The rise in sexually transmitted infections (STIs) in the United States is a major public health concern. Patients frequently utilize urgent care centers for addressing STI-related complaints due to quick appointments, discreetness, and availability. All …
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Urgent Message: Shortness of breath presentations for postpartum patients in urgent care should prompt consideration of venous thromboembolism or peripartum cardiomyopathy, or more benign conditions like deconditioning, bronchitis, or anxiety. Alexa Bailey, DO; Lauren Kostandaras, DO; Hannah Poorman, BS; Michael Weinstock, MD; Catherine Neal, DO. Key Words: Shortness Of Breath, Postpartum, Venous Thromboembolism, VTE, Deep Vein Thrombosis, DVT, Pulmonary Embolism, PE, Peripartum Cardiomyopathy Editor’s Note: The patient case scenario is hypothetical. Abstract Background: The postpartum period introduces a broader range of possible diagnoses for shortness of breath complaints seen in …
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Urgent Message: Although greater occipital nerve block has demonstrated positive effectiveness and few risks as a treatment for acute headache, it is not commonly used. With more familiarity, urgent care clinicians may consider it a useful treatment modality. Elizabeth Reynolds, PA-C, MS Key Words: Migraine, Headaches, Nerve Block Abstract Headaches are a common presentation in urgent care clinics. Various medication options are available but can sometimes be limited for use due to allergies, side effects, poor prior treatment response, and contraindications. Multiple studies have shown high success and low risk …
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Urgent Message: Polymerase chain reaction testing is recommended for patients with lesions that could represent herpes simplex virus infection. It is imperative that urgent care clinicians understand the utility and characteristics of such testing as well as the implications of findings. Brittney Tice, FNP, DNP; Joseph Something, PA; Benjamin Zimmerman, PhD Editor’s Note: The patient case scenario is hypothetical. Abstract In the urgent care (UC) setting, patients commonly present with nominal requests for herpes simplex virus (HSV) testing. HSV infections are common, pleomorphic, and associated with significant stigma. This combination …
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