Clinical

The patient, age 50, is a farmer who presents with flu-like symptoms—fever, chills, productive cough, myalgia, and pleuritic chest pain that developed over a few weeks. What worried him most, however, was a crusted lesion on his arm that was a large verrucous scaly plaque. View the photo and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

Case The patient is a 9-year-old girl who is brought in by her parents shortly after choking on a chicken nugget. They are concerned because even though she stopped gagging, she complains that it feels “like there’s something stuck in there.” View the images, ordered to rule out a lodged foreign body, and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

Case The patient is a 73-year-old woman who presents to the urgent care center with palpitations she says she first noticed 12 days ago. There is no associated chest pain, shortness of breath, abdominal pain, or paresthesias. The patient states she takes warfarin, with recent INR of 2.2. Her personal medical history includes atrial fibrillation, and there is a history of heart disease within the family. Upon examination, you find: General: A&O, NAD, WNWD Lungs: …

Case The patient is a 12-year-old boy who presents with sudden hip pain that started simultaneously with a “popping feeling” in the same hip. He reports that it started in the middle of his football game earlier in the day. View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.