A 51-Year-Old Woman with Multiple Dermatological Symptoms and Muscle Weakness

A 51-Year-Old Woman with Multiple Dermatological Symptoms and Muscle Weakness

The patient is a 51-year-old woman who presented to urgent care complaining of a rash, pruritus, myalgias, and muscle weakness. The rash was an erythematous blanching patch spread across her chest in a V shape. She had also noticed that her fingernail folds were red and swollen. The patient can’t recall when she first noticed her symptoms, but reports that they’ve started affected her everyday life (such as having difficulty rising from a chair) within …

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A 65-Year-Old Man with Epigastric Pain, Dyspnea, and a ‘Clammy’ Feeling

A 65-Year-Old Man with Epigastric Pain, Dyspnea, and a ‘Clammy’ Feeling

Figure 1.   Case The patient is a 65-year-old man with symptoms of epigastric pain over the last 2 hours, with some dyspnea and a “clammy feeling.” He has a history of GERD and has used both an oral antacid and omeprazole within the past hours without relief. Upon exam, you find: General: Alert and oriented. Skin cool and moist Lungs: CTAB Cardiovascular: Regular rate and rhythm without f/r/g Abdomen: Soft and nontender without rigidity, …

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A 57-Year-OId Man with Rib Pain with Deep Breathing

A 57-Year-OId Man with Rib Pain with Deep Breathing

The patient is a 57-year-old man who reports to urgent care complaining of right-sided pain in his ribs when taking deep breaths. He reports that he worked out at his health club that morning before work, but denies any pain at the time or potential cause of injury related to that. Rather, he said the pain began suddenly a couple of hours later while he was at work. View the images taken and consider what …

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Abstracts in Urgent Care-December

More Advice on Inquiring About—and Assessing—Vaping and EVALI Key points: Citation: Siegel DA, Jatlaoui TC, Koumans EH, et al. Update: Interim Guidance for Health Care Providers Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use Associated Lung Injury—United States, October 2019.  MMWR Morb Mortal Wkly Rep.  2019;68:919–927.  Key point: Physicians should inquire about e-cig or vaping use in a nonjudgemental but thorough manner. Ask about specific products, frequency, and associated drug use. …

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Abstracts in Urgent Care-November

What’s New in Flu Vaccine Information New First-In-Class Pleuromutilin Antibiotic for CAP Abdominal Pain in Patients with IUDs—Watch Out for Ectopic Pregnancy Cancer-Causing Chemical Found in Ranitidine Measles Cases and Outbreaks Cooling Pediatric Burns Occ Med: Severe Silicosis in Stone Fabrication Workers   An Update on Vaccine the 2019-2020 Flu Season Key points: The CDC recommends annual influenza vaccination for everyone 6 months of age and older, with any licensed influenza vaccine that is appropriate …

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Updated IDSA Guidelines Stress Early, Appropriate Treatment for Community-Acquired Pneumonia + Influenza

Urgent message: Just as what is predicted to be a brutal flu season picks up steam, the Infectious Diseases Society of America has released new guidelines stressing the need for timely, dual treatment in adults with community-acquired pneumonia who also test positive for influenza. Cornelius O’Leary, Jr., MD After more than a decade, the Infectious Diseases Society of American has published new guidelines on community-acquired-pneumonia—noteworthy for both its switch from narratives to a Grading of …

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For Auld Lange Syne, Many Great Years

The year was 2006: Saddam Hussein was executed for crimes against humanity. The Wii gaming console debuted. Pluto lost its planetary status. High School Musical and Borat were the talk of the town in entertainment. And JUCM, The Journal of Urgent Care Medicine was born—the first and only peer-reviewed journal in the industry (which it remains to this day). Well, let’s just say that JUCM was the undisputed highlight of 2006! The whole idea for …

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Atypical Chest Pain in a Fibromyalgia Patient Presenting to Urgent Care

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. …

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Ear Pain Mimics: It’s Not All About Otitis Media

Ear Pain Mimics: It’s Not All About Otitis Media

Urgent message: Though ear pain is often due to otitis media or externa, it is important to include other diagnoses, some of which could be life-threatening, “can’t miss” causes. Introduction Patient complaints of ear pain (otalgia) are seen frequently in the urgent care setting. It can be frustrating for patients and providers when a patient’s ear pain has no obvious cause. Differential diagnoses include several primary and secondary causes of otalgia. (See Table 1.) Lab …

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A 65-Year-Old Female with Hip Pain After a Stumble

A 65-Year-Old Female with Hip Pain After a Stumble

The Case The patient is a 65-year-old woman who presents with pain in her left hip after stumbling down the last step of her front stoop. Her daughter, who witnessed the incident, reports that her mother did not fall and insists she “didn’t even land that hard” on her left leg. Review the image taken and consider what our diagnosis and next steps would be.

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