Clinical Image Challenges

Case The patient is a 34-year-old woman who has just returned from the first camping trip of the year with her family. She relays that 2 days earlier, as she as she was setting up a tent, she “got stung” by something she didn’t see. As she struggled to free herself of the tent fabric, she was stung several more times on her hand and arm. She never saw the culprit. Not long after, she began vomiting and saw that her skin was erythematous. View the photo and consider what …
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Case The patient is a 17-year-old male who presents to urgent care with anterior knee pain after a fall while mountain biking. However, he states that he’d been experiencing pain for an indeterminate period of time before the incident that preceded his visit. View the image taken (Figure 1) and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page. Figure 1 …
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Figure 1.   The patient is a 42-year-old man with a sensation he describes as his heart “flipping” intermittently for the last 3 days. He denies chest pain, shortness of breath, diaphoresis, or dizziness. Upon exam, you find: General: Alert and oriented X 3, sitting comfortably in a chair Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT View the ECG taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page …
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Case The patient is a 45-year-old woman who presents after experiencing chest pain for the past 2 hours. She has some minimal dyspnea, but no diaphoresis. She takes birth control pills and is a smoker. She denies family history of cardiac disease. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT without r/r/g Ext: No peripheral edema or calf pain, pulses 2+ and equal in all extremities View the ECG taken and consider what the diagnosis and next …
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Case The patient is a 51-year-old man who presents to urgent care complaining of a persistent cough. He reports it started “about a month ago,” but his wife, who is with him, insists it’s been at least 6 weeks. 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 …
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