History: A 67-year-old female presents to urgent care complaining of one episode of syncope earlier in the day. No seizure-like activity was noted by the family and she returned to baseline within a minute. She has a past medical history of end-stage renal disease on scheduled hemodialysis, hypertension, diabetes, coronary artery disease, and chronic nausea. Medications include aspirin, insulin, amlodipine, hydralazine, ondansetron, metoclopramide, and amiodarone. View the ECG taken and consider what your diagnosis …
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A 36-Year-Old Man with Wrist Pain After a Traumatic Impact
The patient is a 36-year-old man who presents with wrist pain after “hitting it on something.” Further history reveals that he punched a wall in a fit of anger and felt sharp pain immediately. He has no past medical history and takes no medications. View the images 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 28-Year-Old Boxer with Wrist Pain After a Bout
The patient is a 28-year-old male with right wrist pain after a boxing match. He reports that he felt “a pop” and immediate pain along the ulnar aspect of his wrist after throwing a punch. He has no past medical history and takes no medications. View the x-ray 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 46-Year-Old Woman with a Painful, Erythematous Plaque on Her Leg
The patient is a 46-year-old female who presents with a painful, erythematous, indurated plaque on her lower leg. She reports that it developed over the past month. At first she attributed the pain to “a bump” of unknown origin, but as the area of red skin expanded she became concerned that she became concerned, as she reports a history of deep-vein thrombosis. View the image taken and consider what your diagnosis and next steps …
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A 34-Year-Old Female with a Syncopal Episode but No Remarkable History
A 34-year-old female with no reported medical history presents to urgent care after a syncopal episode. She describes standing up rapidly to answer the phone, followed by a sensation of lightheadedness and nausea with subsequent collapse. On evaluation, her vital signs are normal, she appears well, and she is currently asymptomatic. View the ECG taken and consider what your diagnosis and next steps would be. (Case presented by Tom Fadial, MD, The University of Texas …
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A 13-Year-Old Boy with Knee Pain After a Fall
The patient is a 13-year-old boy who presents with knee pain after an awkward fall while playing basketball on an asphalt court. He is unable to walk due to pain and has a swollen knee. View the x-rays taken and consider what your diagnosis and next steps would be.
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A 35-Year-Old Male with Shoulder Pain After a Fall
The patient is a 35-year-old male who presents to urgent care with acute pain in his left shoulder after falling during a bicycle ride. Pain is worse with movements, but he is able to range the shoulder somewhat. You observe bruising and swelling at the impact site. View the images taken and consider what your diagnosis and next steps would be.
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A 96-Year-Old Male with Palpitations and a History of CAD
The patient is a 96-year-old man who is brought to your urgent care center by his daughter, with whom he lives. She reports that he has been feeling light-headed for “a few days.” The patient confirms this, adding that he has felt his heart “fluttering,” as well. He denies chest pain and shortness of breath, but acknowledges a history of coronary artery disease. View the ECG and consider what your diagnosis and next steps would …
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A 13-Year-Old Girl with Scaling and Fissures on Her Lips
The patients is a 13-year-old girl who presents to a pediatric urgent care clinic with 1 month of scaling and fissures on her lips which began after she started using a retinoid cream prescribed for acne. 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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A 71-Year-Old Woman with Femur Pain After a Fall
The patient is a 71-year-old female who presents with proximal femur pain after losing her balance and sustaining a “soft” fall onto a carpeted surface. She has a past history of hypertension, hypercholesterolemia, and osteoporosis. She takes a statin, an ACE inhibitor, and a bisphosphonate. 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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