A 45-Year-Old Male with Palpitations

A 45-Year-Old Male with Palpitations

The patient is a 45-year-old male who presents with palpitations for the past 30 minutes. He denies chest pain, dizziness, or syncope. His vital signs are normal aside from tachycardia and he appears to be in no acute distress.               View the ECG taken and consider what your diagnosis and next steps might be. Resolution of the case is described on the next page.

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A 43-Year-Old with a New Rash on the Trunk

A 43-Year-Old with a New Rash on the Trunk

A 43-year-old man presents to urgent care with a rash that he noticed a couple of days ago on his trunk. On exam, there is skin atrophy and multiple smooth papules and hypopigmented oval macules. Upon palpation of the lesions, you find that the examining finger “sinks” into a pit with distinct edges, like the ring of a hernia. The patient is immunocompetent, and his medical history is unremarkable except for lichen planus. He patient …

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A 4-Week-Old Girl with a New Rash on Her Back

A 4-Week-Old Girl with a New Rash on Her Back

A mother brought her 4-week-old daughter to the doctor concerned about a vesicular rash that developed on the girl’s back within the last day. On examination, tiny vesicles in a primarily truncal distribution were seen. The patient had no systemic symptoms and appeared well. 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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An 87-Year-Old Male with Chest Pain, SOB, and a History of Valvular AFib, Stroke, and Heart Failure

An 87-Year-Old Male with Chest Pain, SOB, and a History of Valvular AFib, Stroke, and Heart Failure

An 87-year-old male with past medical history of valvular atrial fibrillation, prior stroke, and heart failure presents to urgent care with chest pain and shortness of breath for 3 days. The pain and difficulty breathing are associated with bilateral lower extremity swelling for 1 week.               View the ECG 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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A 43-Year-Old Woman with a New Ulcer on One Hand

A 43-Year-Old Woman with a New Ulcer on One Hand

A 43-year-old woman presents with 2 weeks of a smooth nodule on her right hand. The patient denies recent travel but recalls that she “banged up” her hand while cleaning out a fresh-water fish tank prior to noticing the nodule. Past medical history is significant for renal transplantation. Exam reveals a tender, erythematous plaque with an ulcer on dorsal aspect of her hand.               View the image and consider what your diagnosis and next steps …

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39-year-old Male with Sharp, Nonradiating Chest Pain

39-year-old Male with Sharp, Nonradiating Chest Pain

History: A 39-year-old male with no known past medical history presents to urgent care for evaluation of several hours of sharp, non-radiating, left-sided chest pain. The pain is non-exertional, non-pleuritic, began after his last meal and resolved without intervention approximately 30 minutes prior to arrival. No history of similar pain in the past. No associated shortness of breath, nausea, vomiting, or diaphoresis. View the ECG taken and consider what your diagnosis and next steps would …

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