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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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 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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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 …

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A 61-Year-Old Man Who Is Lightheaded and Dizzy

A 61-Year-Old Man Who Is Lightheaded and Dizzy

Case The patient is a 61-year-old man who presents to the urgent care center with lightheaded dizziness, which he says started several hours prior to arrival. He denies chest pain, syncope, and shortness of breath but says he feels “clammy.” He is not taking any medications on a regular basis has no history of myocardial infarction, but he had a stent placed 8 years ago. Upon exam, you find: General: Alert and oriented X 3, …

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A 28-Year-Old Man Complaining of Tiredness, Myalgia, and Sore Throat

A 28-Year-Old Man Complaining of Tiredness, Myalgia, and Sore Throat

Case The patient is a 28-year-old man who presents to urgent care with a fever and complaints of tiredness, myalgia, and sore throat. You note that he has pink, scaly papules on his palms and soles. He also has patchy alopecia developing on his scalp, which he says is a very recent development. View the photo and consider what your diagnosis and next steps would be. Resolution of the case is described on the next …

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A 52-Year-Old Man with Recent-Onset Dizziness

A 52-Year-Old Man with Recent-Onset Dizziness

Case A 52-year-old man presented to urgent care with a 2-day history of dizziness. He denies chest pain, syncope, shortness of breath, or diaphoresis. He is not taking any medications, and has no noteworthy personal medical history. Upon exam, you find: General: Alert and oriented X 3, slightly pale Lungs: CTAB Cardiovascular: Irregularly irregular and tachycardic without murmur, rub, or gallop Abdomen: Soft and NT, no pulsatile mass Ext: No peripheral edema, pulses are 2+ …

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A Toddler with a Sudden Limp

A Toddler with a Sudden Limp

Case The patient is a 3-year-old female who is brought to your urgent care center by her parents, who report that she has been limping and crying intermittently seemingly without reason for the past several hours. Her father says she cries acutely when picked up, but that she calms down quickly with comforting. View the images taken (Figure 1 and Figure 2) and consider what the diagnosis and next steps would be. Resolution of the …

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A 3-Year-Old Girl with Vesicles on Her Palms and Soles

A 3-Year-Old Girl with Vesicles on Her Palms and Soles

Case A 3-year-old girl was brought to urgent care with small widespread vesicles, including on her palms and soles. She had begun to develop painful oral vesicles, as well, and was refusing to eat. The rash began a few days after flu-like symptoms of fever, sore throat, cough, and headache. View the photo and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.

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A 34-Year-Old Woman with an Unidentified Insect Sting

A 34-Year-Old Woman with an Unidentified Insect Sting

Case The patient is a 34-year-old woman who has just returned from the first camping trip of the year with her family. She relays that 2 days earlier, as she as she was setting up a tent, she “got stung” by something she didn’t see. As she struggled to free herself of the tent fabric, she was stung several more times on her hand and arm. She never saw the culprit. Not long after, she …

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