A 16-Year-Old with Severe Pain and Immobility After a Basketball Mishap

Case The patient is a high school athlete who is brought to your urgent care center with severe pain in the area of his right foot and ankle. He reports that he jumped for a rebound, landing hard on another player’s foot with his full weight on his right foot. View the images taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page. Figure 1.   Figure 2. Figure 3 …
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A 62-Year-Old Woman with Palpitations

     Case The patient is a 62-year-old woman who presents to your urgent care center with a feeling of palpitations, which began the previous evening. She has no chest pain or shortness of breath, but does feel “clammy.” She takes no medications. Her history includes MI and CABG 5 years ago. Upon exam, you find: General: Alert and oriented X 3, skin color good but clammy Lungs: CTAB Cardiovascular: Tachycardic and regular without murmur, rub, or gallop Abdomen: Soft and NT, no pulsatile mass Ext: No peripheral edema, pulses …
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A 72-Year-Old Man with Black Skin Lesions

Case A 72-year-old man brought his wife into the urgent care center because she woke up with a raw throat and fever. However, he also asks to see a clinician to ask about multiple black skin lesions on his cheeks and eyelids. Once in the exam room, he notes that he spent more than 40 years in the landscaping business, getting considerable sun exposure. He knows that put him at risk for skin cancer. In addition, he recently quit smoking after 48 years. View the photo and consider what your …
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A Runner with a History of Foot Pain

Case The patient is a 27-year-old male who presents to urgent care with foot pain, for which he says there is no explanation. With probing, he reveals that he is a “fanatic” about running, and that the pain has persisted for close to 7 months. View the images taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.   Differential Diagnosis Capsulitis Freiberg disease Metatarsal stress fracture Metatarsalgia Tendinitis …
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A 61-Year-Old Man Who Is Lightheaded and Dizzy

Case The patient is a 61-year-old man who presents to the urgent care center with lightheaded dizziness, which he says started several hours prior to arrival. He denies chest pain, syncope, and shortness of breath but says he feels “clammy.” He is not taking any medications on a regular basis has no history of myocardial infarction, but he had a stent placed 8 years ago. Upon exam, you find: General: Alert and oriented X 3, mildly tachypneic, skin color good but slightly moist Lungs: CTAB Cardiovascular: Tachycardic and regular without …
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