A 7-Year-Old Boy with Scaly Red-Brown Papules on His Trunk

A 7-Year-Old Boy with Scaly Red-Brown Papules on His Trunk

A 7-year-old boy is brought to your urgent care center by his mother because she’s concerned about a rash of scaly papules on his trunk, some of which had crusted or healed. A few of the lesions are hemorrhagic. She notes that they appeared a few days ago, accompanied by a mild fever. She dismissed the possibility that the source could be chickenpox because her son had been vaccinated. The boy reports that the papules …

Read More
A 61-Year-Old Woman with a 2-Day History of Chest Pain

A 61-Year-Old Woman with a 2-Day History of Chest Pain

A 61-year-old female presents to urgent care with chest pain for 2 days. She describes it as “mild right now” but that it varies in intensity; it was so severe the previous night that it kept her from sleeping. Today the pain has been stuttering, lasting a couple of minutes at a time. Pain is substernal, nonradiating, and is associated with vomiting and diaphoresis. Vital signs are normal. View the ECG and consider what your …

Read More
A 28-Year-Old with Foot Pain After a Fall

A 28-Year-Old with Foot Pain After a Fall

The patient is a 28-year-old female who presents with pain in her left foot after a fall of roughly 10 feet while rock-climbing. She reports that she “landed hard” with the left foot taking the full force of the impact. On exam, she had left midfoot dorsal and plantar tenderness and bruising across top of foot. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is …

Read More
A 71-Year-Old with Diabetes and Discoloration of the Skin

A 71-Year-Old with Diabetes and Discoloration of the Skin

The patient is a 71-year-old female with type 2 diabetes who calls attention to a rash on her shins during an annual physical. The rash appears to be pink, atrophic scars surrounded by hyperpigmented patches. They have developed since her last physical. She denies discomfort but is concerned as to what could have caused them. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described …

Read More
A 57-Year-Old Female with Cardiological History and Shortness of Breath

A 57-Year-Old Female with Cardiological History and Shortness of Breath

The patient is a 57-year-old female with a history of coronary artery disease, congestive heart failure, and left ventricular thrombus on warfarin who presents with shortness of breath. She denies any bleeding, bruising, dark-colored stools, chest pain, fever, cough, or leg pain. On evaluation, the patient’s vital signs are normal. She is breathing comfortably and speaking in complete sentences. View the ECG and consider what your next steps and diagnosis would be. Resolution of the …

Read More
A 70-Year-Old Female with Nonradiating Chest Pain

A 70-Year-Old Female with Nonradiating Chest Pain

A 70-year-old female with history of coronary artery disease presents to urgent care with nonradiating chest pain of 2 days’ duration. She has a known history of left bundle branch block.               Baseline ECG: View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Benjamin Cooper, MD, McGovern Medical School, Department of Emergency Medicine, The University of Texas …

Read More
An 8-Year-Old Boy with Scaly Papules on the Knees and Elbows

An 8-Year-Old Boy with Scaly Papules on the Knees and Elbows

During a regular check-up, a mother remarks that her 8-year-old son had developed clusters of follicular, scaly papules bilaterally on his knees and elbows “over the past few weeks.” They didn’t seem to bother him, but because her son is prone to allergies the mother wondered if changes in household substances like soap or laundry detergent could be responsible. View the photo and consider what your diagnosis and next steps would be. Resolution of the …

Read More
A 34-Year-Old Man with Pain and Burning in Both Eyes

A 34-Year-Old Man with Pain and Burning in Both Eyes

The patient is a 34-year-old male who presents with bilateral ocular pain and burning. He is noted to have excessive tearing and continuous eye rubbing. He comments that his eyes itch persistently and that both eyes feel as if there is something in them. Scaly plaques and crust are visible along the top and bottom eyelid. View the picture taken and consider what your diagnosis and next steps would be. Resolution of the case is …

Read More