A 42-Year-Old Man with Skin Petechia and Palpable Purpura on His Legs

A 42-Year-Old Man with Skin Petechia and Palpable Purpura on His Legs

The patient is a 43-year-old man who presents to urgent care with widespread skin petechia and palpable purpura on his legs. He reports these symptoms occurred around 2 weeks after he recovered from an upper respiratory tract infection. In addition, he’s experienced fever, diarrhea, and vomiting. He mentions pain in his scrotum, as well. View the photo (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case is described …

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A 60-Year-Old Man with a 2-Year History of Dizziness

The patient is a 60-year-old man with a 2-year history of dizziness. He denies chest pain, shortness of breath, diaphoresis, vomiting/diarrhea, or fever. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop, occasional irregular beats Abdomen: Soft and NT without r/r/g View the ECG 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 45-Year-Old Male with Sudden Eye Pain

A 45-year-old man presents with bilateral ocular pain, excessive tearing, and bloodshot eyes. He reports that his symptoms began 2 days ago with the sensation of a foreign body lodged in his eye, and that his eyes have been unusually sensitive to light. He has not worn his contacts since the onset of symptoms. View the photo and consider what your diagnosis and next steps would be. Resolution of the case is described on the …

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A 51-Year-Old Man with Shortness of Breath and ‘Burning’ in His Chest

The patient is a 51-year-old man with shortness of breath and an intermittent burning sensation in his chest. His symptoms began 2 days ago. Upon exam, you find: General: Alert and oriented Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT without r/r/g View the ECG 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 3-Year-Old with Lesions on His Thumb

A 3-Year-Old with Lesions on His Thumb

A mother brings her 3-year-old son to urgent care with multiple skin lesions on his thumb, which he frequently sucked for comfort. The grouped configuration of lesions was painful and had developed over the last 5 days to become vesicles. Upon exam, you note that the boy has a nearly healed cold sore on his lip, pain in his wrist, and an elevated temperature. View the photo and consider what your diagnosis and next steps …

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A 21-Year-Old Male with Persistent Ankle Pain Following Trauma

The patient is a 21-year-old male who presents with persistent ankle pain 4 weeks after suffering a trauma. He fell while scaling the exterior of his dormitory, trying to gain entry into a second-floor window because he’d locked his keys inside. 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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