A 50-Year-Old Farmer with Flu-Like Symptoms

A 50-Year-Old Farmer with Flu-Like Symptoms

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.

Read More
A 9-Year-Old Girl Who Choked on a Chicken Nugget

A 9-Year-Old Girl Who Choked on a Chicken Nugget

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.

Read More
A 73-Year-Old Woman with a 12-Day History of Palpitations

A 73-Year-Old Woman with a 12-Day History of Palpitations

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: …

Read More
A 12-Year-Old Football Player with Sudden Hip Pain

A 12-Year-Old Football Player with Sudden Hip Pain

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.

Read More
A 45-Year-Old Woman with Suddenly Discolored Skin

A 45-Year-Old Woman with Suddenly Discolored Skin

Case A 45-year-old woman presents with a complaint of “a brown spot” on her back. Upon examination, you confirm there is a reticular hyperpigmented patch of skin, which she says she noticed after using a heating pad to relieve myalgia after working in her garden. She confesses that she fell asleep with the heating pad on the area, she thinks for several hours. View the photo and consider what your diagnosis and next steps would …

Read More
A 52-Year-Old Man Who Is Lightheaded and Dizzy

A 52-Year-Old Man Who Is Lightheaded and Dizzy

    Case The patient is a 52-year-old man who presents to your urgent care center with lightheaded dizziness, which he says has been present for the past 3 days. It is worse with standing. He reports that he has been spending a lot of time in the sun lately. He denies chest pain, shortness of breath, abdominal pain, or paresthesias. He does not take any medications. His personal medical history untreated hypertension, and there …

Read More
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 …

Read More
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, …

Read More
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 …

Read More
A Runner with a History of Foot Pain

A Runner with a History of Foot Pain

Case The patient is a 27-year-old male who presents to urgent care with foot pain, for which he says there is no explanation. With probing, he reveals that he is a “fanatic” about running, and that the pain has persisted for close to 7 months. View the images taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.     Differential Diagnosis Capsulitis Freiberg …

Read More