A 25-Year-Old Woman with Plaques on Her Elbows and Feet

A 25-Year-Old Woman with Plaques on Her Elbows and Feet

The patients is a 25-year-old woman who presents with 1 month of smooth, red-brown plaques on her elbows and the tops of her feet which are pruritic. The lesions are round with a slightly darker ring on the outside, with no scaling or significant surface change to the skin. She has no systemic symptoms. View the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the …

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A 74-Year-Old Female with Multiple Episodes of Chest Pain Over a 2-Day Period

A 74-Year-Old Female with Multiple Episodes of Chest Pain Over a 2-Day Period

A 74-year-old female presents to urgent care complaining of two episodes of chest pain in the past 2 days. The pain is midsternal, squeezing, does not radiate, and began at rest. The patient denies associated nausea, vomiting, diaphoresis, cough, lower extremity swelling or pain. Personal medical history is remarkable for hypertension, asthma, and diabetes.             View the ECG ordered and consider what your diagnosis and next steps would be. Resolution of the case is described …

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A 24-Year-Old Man with Excessively Odorous and Itchy feet

A 24-Year-Old Man with Excessively Odorous and Itchy feet

The patient is a 24-year-old man who presents with excessive foot odor that he describes as “worse than anything I could have imagined.” He denies pain or burning, but reports that the soles of his feet itch occasionally. He also says his feet sweat heavily when he plays recreational ice hockey a few nights a week. Upon examination, several shallow rounded pits are found on the pressure-bearing areas of the soles.             View the image …

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A 48-Year-Old Female with Months of Fatigue, Nausea, and Body Aches—Including Chest Pain

A 48-Year-Old Female with Months of Fatigue, Nausea, and Body Aches—Including Chest Pain

The patients is a 48-year-old female with a family history of breast cancer who complains of 2 months of fatigue, nausea, and generalized body aches, including chest pain. She reports 40 pounds of unintentional weight loss during this time. Review the ECG taken and consider what other tests you would order, as well as possible diagnoses. (Case presented by Tom Fadial, MD, McGovern Medical School Department of Emergency Medicine.)

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A 33-Year-Old Woman with Blanching on Her Lower Legs

A 33-Year-Old Woman with Blanching on Her Lower Legs

A 33-year-old woman presents to urgent care with symmetrical multiple blanching nodules that developed on her lower legs over the course of 2 weeks. The lesions were round and tender. She had also been fighting a fever, fatigue, and joint pain over the same period. Her only current prescription was for oral contraceptives.             View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on …

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A 46-Year-Old Man with ‘Burning’ Epigastric Pain of Several Hours Duration

A 46-Year-Old Man with ‘Burning’ Epigastric Pain of Several Hours Duration

The patient is a 46-year-old male who presents epigastric pain that started several hours ago after a large meal. He describes the pain as a “burning” sensation. His personal medical history is notable for seizures. View the ECG and consider what your diagnosis and next steps would be. (Case presented by Benjamin Cooper, MD, FACEP, The University of Texas Health Science Center at Houston.)

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A 35-Year-Old Man with Shoulder Pain Weeks After a Car Accident

A 35-Year-Old Man with Shoulder Pain Weeks After a Car Accident

The patient is a 35-year-old male who presents with shoulder pain and weakness. He reports that the pain began when he had a “fender bender” 3 weeks ago. At the time, he didn’t think the pain was severe enough to warrant attention but he’s concerned that it’s “taking too long to get over this.” View the images taken and consider what your diagnosis and next steps would be.

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An 8-Year-Old Girl with Lesions on Her Arms

An 8-Year-Old Girl with Lesions on Her Arms

The patient is an 8-year-old girl with a smattering of brown to black lesions on her arms. They’re not painful or causing discomfort, but her mother is concerned because they look darker than the average freckle. Exam reveals small (less than 0.5 mm), round, hyperpigmented macules.             View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. <

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