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 …

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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 …

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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 …

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A 5-Year-Old with Foot Pain of Unknown Origin

A 5-Year-Old with Foot Pain of Unknown Origin

A father brings his 5-year-old son to your urgent care center with a primary complaint of pain in his right foot. There was no report of trauma or injury. Dad has noticed the boy limping for the past few days and he points to the right foot. You note swelling in the midfoot area. The boy’s pain is evident as he walks with a limp and has tenderness in the area of swelling on the …

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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 …

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A 38-Year-Old Female with Abdominal Pain and Chest Tightness

A 38-Year-Old Female with Abdominal Pain and Chest Tightness

A 38-year-old female with no past medical history presents to an urgent care with right upper quadrant abdominal pain and chest tightness, worsening for 1 week. She reports that her chest tightness is associated with shortness of breath, and is worse when walking and lying on her side. She denies fever, cough, dysuria, headache, or weakness. View the ECG and consider what your diagnosis and next steps would be. (Case presented by Catherine Reynolds, MD, …

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A 24-Year-Old Man with Ankle Pain After a Fall

A 24-Year-Old Man with Ankle Pain After a Fall

The patient is a 24-year-old male who reports to urgent care with right ankle pain after falling from a ladder while cleaning out the gutters at his parents’ home. He reports that he was only a few rungs up but that he landed “awkwardly” and immediately felt a sharp pain on the front of the ankle. He is unable to bear weight but denies any numbness or tingling. View the x-ray taken and consider what …

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A 32-Year-Old Male with Pain After Dropping a 20-Pound Weight on his Finger

A 32-Year-Old Male with Pain After Dropping a 20-Pound Weight on his Finger

The patient is a 32-year-old man who presents with pain over the distal phalanx of the middle finger after dropping a 20-pound weight on his finger while constructing a home gym set-up. The skin is unbroken, but pain is evident upon palpation over the distal phalanx of the middle finger. Neurovascular status is intact.               View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case …

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