Syphilis in the Urgent Care Center

Syphilis in the Urgent Care Center

Urgent message: Seeking information beyond the stated history  can prompt  important information that informs the true diagnosis. This is especially true in patients  with a complicated or potentially embarrassing history.  Case Presentation A 59-year-old female with a past medical history of type 2 diabetes and hypertension presents to an urgent care facility with complaints of abdominal pain. She is well known to the urgent care staff. She is consistently noncompliant with medical care. Her hypertension …

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

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 …

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Abstracts In Urgent Care – October 2018

New Data Show ‘Steep and Sustained’ Increase in STD Occurrence—Especially Syphilis Key point: Over the past 5 years, rates of syphilis, gonorrhea, and chlamydia have all increased in the United States, with syphilis cases almost doubling and cases of antibiotic-reistant gonorrhea rising. Citation: Centers for Disease Control and Prevention. 2018 STD Prevention Conference. New CDC Analysis Shows Steep and Sustained Increases in STDs. August 28, 2018. Available at: https://www.cdc.gov/nchhstp/newsroom/2018/2018-std-prevention-conference.html#Graphics. Accessed September 7, 2018. Every other …

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A 62-Year-Old Woman with Palpitations

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, …

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A 32-Year-Old Male with Unsteady Gait

A 32-Year-Old Male with Unsteady Gait

Urgent message: Early diagnosis and management of multiple sclerosis are crucial for long-term prognosis. Urgent care providers must be vigilant with proper history taking and thorough physical examination when looking for signs and symptoms of early MS. Waqas Memon, MD, Zonaira Shabbir, OMS IV, and Muhammad Akhtar, MD, FACP Introduction In the early course of multiple sclerosis (MS), the initial symptoms are nonspecific and intermittent, which makes the diagnosis challenging.1 Focusing on common symptoms and …

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A 72-Year-Old Man with Black Skin Lesions

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 …

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Employing the Parental Papoose Technique in Treating Young Children

Employing the Parental Papoose Technique in Treating Young Children

Urgent message: Children presenting to the urgent care center are often in a state of distress and agitation—to the extent that they may be difficult to treat when it comes to certain procedures. The parental papoose technique may help soothe the patient—and the parent—making effective treatment more accessible. Oscar D. Almeida, Jr., MD, FACOG, FACS It is common for a young child to enter our urgent care center calmly—while being held by a parent, only …

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Urgent Care and Antibiotics: Advancing Care and Stewardship

Antimicrobial stewardship is defined as a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms. Stewardship initiatives in the hospital are paving the way for the rest of healthcare through education campaigns, monitoring, and restrictions. Outpatient practice is beginning to catch up as the stories of resistance grow and the lines between nosocomial and community-acquired infections blur. …

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The Approach to the Hypertensive Patient in the Urgent Care Setting

The Approach to the Hypertensive Patient in the Urgent Care Setting

Urgent message: Previously undiagnosed hypertension is common among ambulatory patients, and urgent care providers are often the first to recognize and diagnose this condition. Initiating treatment, testing, and providing patient education and follow-up are well within the scope of urgent care practice and help ensure positive outcomes. Being attentive to the presentation and care of hypertensive emergencies is also paramount.   Taylor Fischer MMS, PA-C and Rebecca L. McClough, MPAS PA-C   Hypertension (HTN) affects …

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Abstracts in Urgent Care – September 2018

WHO Announces ICD-11, Coming Next Year Key point: New set will reflect current terminologies and classifications, integrate more smoothly with new technologies. Citation: World Health Organization. WHO Releases New International Classification of Diseases (ICD 11). June 18, 2018. Available at: http://www.who.int/news-room/detail/18-06-2018-who-releases-new-international-classification-of-diseases-(icd-11). Accessed August 14, 2018. ICD-10 was released in 2015, but according to the World Health Organization (WHO) we can already expect the next revision, ICD-11, sometime early in the next decade. ICD-11 is supposed …

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