A 6-Year-Old Boy with a Lesion on His Ear

A 6-Year-Old Boy with a Lesion on His Ear

The patient, a 6-year-old boy, presented to a pediatric urgent care center for a well-child visit. In the exam room, the father pointed out a red lesion on the helical rim of the patient’s ear. The papule was smooth and well-defined and didn’t seem to bother the boy. The father reports that he and the boy’s mother have grown concerned as they’ve noticed it develop over several months. View the image and consider what your …

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A 65-Year-Old Man with Shortness of Breath and a History of Heart Failure

A 65-Year-Old Man with Shortness of Breath and a History of Heart Failure

A 65-year-old male with a history of heart failure presents to an urgent care center with shortness of breath of 2 days duration. He denies chest pain, nausea, or vomiting. He reports that he ran out of his medications about a week ago. View the ECG and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page. (Case presented by Catherine Reynolds, MD, McGovern Medical School, …

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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 …

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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 …

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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 …

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A 10-Year-Old Boy Who Twisted His Knee in the Backyard

A 10-Year-Old Boy Who Twisted His Knee in the Backyard

The patient is a 10-year-old boy who presents after twisting his right knee while playing a backyard game of badminton. The pain is such that he is unable to bear weight on the leg.               View the image taken (Figure 1) 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 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 …

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