A 71-Year-Old Woman with Femur Pain After a Fall

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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A 7-Year-Old Girl with White Patches on Her Toenails

A 7-Year-Old Girl with White Patches on Her Toenails

Case A mother brought her 7-year-old daughter to the pediatric urgent care center after noticing that several of the girl’s toenails on each foot had white patches and appeared short and broken. They seemed to be lifting off the nail beds and looked thinner than usual.             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 60-Year-Old Woman with Hypertension, Diabetes, and Sudden Fatigue and Weakness

A 60-Year-Old Woman with Hypertension, Diabetes, and Sudden Fatigue and Weakness

A 60-year-old female with a history of hypertension and diabetes presents to urgent care with fatigue and weakness for 1 day. Her son states she has not been able to get out of bed today because she’s “too tired to walk.” She denies any complaints of chest pain, nausea, vomiting, shortness of breath, or fever. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is described …

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A 25-Year-Old Woman with Plaques on Her Elbows and Feet

A 25-Year-Old Woman with Plaques on Her Elbows and Feet

The patients is a 25-year-old woman who presents with 1 month of smooth, red-brown plaques on her elbows and the tops of her feet which are pruritic. The lesions are round with a slightly darker ring on the outside, with no scaling or significant surface change to the skin. She has no systemic symptoms. View the image and consider what your diagnosis and next steps would be. Resolution of the case is described on the …

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A 74-Year-Old Female with Multiple Episodes of Chest Pain Over a 2-Day Period

A 74-Year-Old Female with Multiple Episodes of Chest Pain Over a 2-Day Period

A 74-year-old female presents to urgent care complaining of two episodes of chest pain in the past 2 days. The pain is midsternal, squeezing, does not radiate, and began at rest. The patient denies associated nausea, vomiting, diaphoresis, cough, lower extremity swelling or pain. Personal medical history is remarkable for hypertension, asthma, and diabetes.             View the ECG ordered and consider what your diagnosis and next steps would be. Resolution of the case is described …

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A 24-Year-Old Man with Excessively Odorous and Itchy feet

A 24-Year-Old Man with Excessively Odorous and Itchy feet

The patient is a 24-year-old man who presents with excessive foot odor that he describes as “worse than anything I could have imagined.” He denies pain or burning, but reports that the soles of his feet itch occasionally. He also says his feet sweat heavily when he plays recreational ice hockey a few nights a week. Upon examination, several shallow rounded pits are found on the pressure-bearing areas of the soles.             View the image …

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A 48-Year-Old Female with Months of Fatigue, Nausea, and Body Aches—Including Chest Pain

A 48-Year-Old Female with Months of Fatigue, Nausea, and Body Aches—Including Chest Pain

The patients is a 48-year-old female with a family history of breast cancer who complains of 2 months of fatigue, nausea, and generalized body aches, including chest pain. She reports 40 pounds of unintentional weight loss during this time. Review the ECG taken and consider what other tests you would order, as well as possible diagnoses. (Case presented by Tom Fadial, MD, McGovern Medical School Department of Emergency Medicine.)

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