An 11-Year-Old Boy with Forearm and Wrist Pain After a Fall

An 11-Year-Old Boy with Forearm and Wrist Pain After a Fall

The patient is an 11-year-old boy who presents complaining of pain in his left and right forearm and wrist after falling from a height of approximately 5 feet. His parents report that he was attempting to hang upside down by his knees from a chin-up bar in his school’s gymnasium when he slipped. View the images taken and consider what the diagnosis and next steps would be. Resolutions of the case is described on the …

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A 27-Year-Old Man with a Lesion on One Hand

A 27-Year-Old Man with a Lesion on One Hand

A 27-year-old man presents complaining of a single skin lesion on his hand. He reports that it first appeared as a smooth nodule that ulcerated and spread in a lymphangitic fashion. He grew worried when he started to have a fever. The only unusual activity he’d done in the last few weeks was clean out one of his large saltwater aquariums to prepare for purchasing new fish. View the photo and consider what your diagnosis …

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A 57-Year-Old Man with 3 Days of Lightheadedness

A 57-Year-Old Man with 3 Days of Lightheadedness

The patient is a 57-year-old man who complains of lightheadedness for the last 3 days. He has a history of a heart stent placed 4 years ago and has been asymptomatic since that time. He denies vomiting, diarrhea, chest pain, shortness of breath, abdominal pain, or paresthesias. No recent travel. He takes metoprolol and clopidogrel. There is a family history of hypertension Upon exam, you find: General: Sitting comfortably in a chair, alert, breathing comfortably …

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A 50-Year-Old Farmer with Flu-Like Symptoms

A 50-Year-Old Farmer with Flu-Like Symptoms

The patient, age 50, is a farmer who presents with flu-like symptoms—fever, chills, productive cough, myalgia, and pleuritic chest pain that developed over a few weeks. What worried him most, however, was a crusted lesion on his arm that was a large verrucous scaly plaque. 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 9-Year-Old Girl Who Choked on a Chicken Nugget

A 9-Year-Old Girl Who Choked on a Chicken Nugget

Case The patient is a 9-year-old girl who is brought in by her parents shortly after choking on a chicken nugget. They are concerned because even though she stopped gagging, she complains that it feels “like there’s something stuck in there.” View the images, ordered to rule out a lodged foreign body, and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

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A 73-Year-Old Woman with a 12-Day History of Palpitations

A 73-Year-Old Woman with a 12-Day History of Palpitations

Case The patient is a 73-year-old woman who presents to the urgent care center with palpitations she says she first noticed 12 days ago. There is no associated chest pain, shortness of breath, abdominal pain, or paresthesias. The patient states she takes warfarin, with recent INR of 2.2. Her personal medical history includes atrial fibrillation, and there is a history of heart disease within the family. Upon examination, you find: General: A&O, NAD, WNWD Lungs: …

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A 12-Year-Old Football Player with Sudden Hip Pain

A 12-Year-Old Football Player with Sudden Hip Pain

Case The patient is a 12-year-old boy who presents with sudden hip pain that started simultaneously with a “popping feeling” in the same hip. He reports that it started in the middle of his football game earlier in the day. View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.

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A 45-Year-Old Woman with Suddenly Discolored Skin

A 45-Year-Old Woman with Suddenly Discolored Skin

Case A 45-year-old woman presents with a complaint of “a brown spot” on her back. Upon examination, you confirm there is a reticular hyperpigmented patch of skin, which she says she noticed after using a heating pad to relieve myalgia after working in her garden. She confesses that she fell asleep with the heating pad on the area, she thinks for several hours. View the photo and consider what your diagnosis and next steps would …

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A 52-Year-Old Man Who Is Lightheaded and Dizzy

A 52-Year-Old Man Who Is Lightheaded and Dizzy

    Case The patient is a 52-year-old man who presents to your urgent care center with lightheaded dizziness, which he says has been present for the past 3 days. It is worse with standing. He reports that he has been spending a lot of time in the sun lately. He denies chest pain, shortness of breath, abdominal pain, or paresthesias. He does not take any medications. His personal medical history untreated hypertension, and there …

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