A 55-Year-Old Female with Hip Pain

A 55-Year-Old Female with Hip Pain

The patient is a 55-year-old woman who presents with what she calls minor pain in her left hip. She denies any trauma, and insists the pain “isn’t that bad.” She’s only seeking care as a precautionary measure in advance of a family camping trip. View the image 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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Guttate Psoriasis: An Uncommon Cause of a Rash

Guttate Psoriasis: An Uncommon Cause of a Rash

Urgent message: While skin-related complaints are not uncommon in the urgent care setting, with psoriasis being a relatively common source, evaluation and diagnosis of a rash can be challenging. This is especially true in the case of a rare variant like guttate psoriasis.  Chasity L. Falls, MS, PA-C INTRODUCTION Psoriasis is a common condition. However, the guttate variant is rarer, commonly affecting children and young adults less than 40 years of age and accounting for …

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Abstracts in Urgent Care April 2020

JUCM 0420 Abstracts  COVID-19: The Long View Quarantine Duration in Suspected COVID-19 Bedside Ultrasound Use with COVID-19 Fluoroquinolones and Arrhythmia Isopropyl Alcohol and Nausea Relief Patient Preferences Re: the ED vs Urgent Care  The Nuts and Bolts of COVID-19 Key Points: Most patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19 experience mild URI symptoms; however, the virus tends to cause disproportionately severe illness in older and chronically ill adults. …

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A 72-Year-Old Female with Lesions on Her Lower Legs

A 72-Year-Old Female with Lesions on Her Lower Legs

The patient is a 72-year-old woman who complains of multiple skin lesions on her lower legs. She says she first noticed them several months ago, appearing in a net-like pattern, then becoming painful ulcerations, and finally leaving atrophic scars. She is concerned because she had already had several bouts of deep vein thrombosis. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the …

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Rhabdomyolysis in the Urgent Care: An Unexpected Case of Myalgias

Rhabdomyolysis in the Urgent Care: An Unexpected Case of Myalgias

Urgent message: Rhabdomyolysis has a wide range of presentations, from asymptomatic to life-threatening. The most dramatic presentation can result in acute renal failure, electrolyte imbalances, and/or disseminated intravascular coagulation (DIC).  Jordan Miller, DO, Ari Leib, MD, and Andre Bonnet, DO EPIDEMIOLOGY Approximately 26,000 cases of rhabdomyolysis are reported in America yearly, with 10% to 50% progressing to acute renal failure.1,2 Mortality rates range from 7% to 80% and are higher in patients who develop multiorgan …

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A 54-Year-Old Female with Nonproductive Cough and Rhinorrhea

A 54-Year-Old Female with Nonproductive Cough and Rhinorrhea

The patient is a 54-year-old female woman who presents to urgent care with a 3-day history of nonproductive cough with associated rhinorrhea. She does endorse some chest pain after coughing episodes, which resolve with NSAIDs. She otherwise denies nausea, vomiting, diaphoresis, or exertional symptoms. Personal medical history is remarkable for hypertension. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

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Bariatric Surgery Complications in the Urgent Care Center

Bariatric Surgery Complications in the Urgent Care Center

  Urgent message: Obesity continues to be a significant health problem in the United States, with more and more patients opting for a surgical solution to their own weight loss challenges. As this trend continues, urgent care providers can expect to see more patients with post bariatric surgery complaints, ranging from the typical and benign to pulmonary emboli, anastomotic leaks, and respiratory failure account. Tracey Quail Davidoff, MD, FCUCM Obesity has become one of the …

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Abstracts in Urgent Care

Take a Seat—Your Patients Will Thank You Buddy Taping vs Plaster Casting in Boxer’s Fractures Efficacy of Baclofen in Back Pain Rapid Testing for Gonorrhea and Chlamydia Five- vs 10-day Treatment for Strep Throat A Better Screening Test for ACL Rupture Yijung Russell, MD Sitting During an Encounter Is an Easy Way to Increase Patient Satisfaction Key Point: If a provider sits during an encounter, the patient feels that they care more, listen more, inform …

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Urgent Care Is the Best Place for Patients with ‘Hypertensive Urgencies’: Why We Should Stop Sending Patients with Asymptomatically High Blood Pressure to the ED

Most public health campaigns, with a few notable exceptions, have been abject failures. One undeniably successful example, however, has been awareness of the dangers of high blood pressure. As recently as the early 1970s, when the Framingham Study was published, there was still considerable disagreement in the medical community about the risks of untreated hypertension. But in the face of mounting evidence, it soon became clear that persistently elevated blood pressure was dangerous to a …

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When Is Tachycardia in a Patient with URI Symptoms a Sign of Something More Serious?

When Is Tachycardia in a Patient with URI Symptoms a Sign of Something More Serious?

Urgent message: Brugada syndrome is a genetic disorder associated with increased incidence of ventricular tachyarrhythmias and sudden cardiac death. There have been cases associated with fever, viral infections, and pneumonias—all conditions urgent care clinicians treat in abundance. This case report demonstrates how urgent care providers can diagnose a potentially lethal disorder when patients are being seen for febrile illnesses. Kathleen B. Raschka, MD Case Presentation A 55-year-old male with a history of hypertension, hyperlipidemia, and …

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