Practice Management
Figure 1. The patient is a 42-year-old man with a sensation he describes as his heart “flipping” intermittently for the last 3 days. He denies chest pain, shortness of breath, diaphoresis, or dizziness. Upon exam, you find: General: Alert and oriented X 3, sitting comfortably in a chair Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT View the ECG taken and consider what the diagnosis and next steps would be. …
Read More
The patient is a 90-year-old woman who presents to urgent care with a 2-week history of intermittent lightheadedness. She denies syncope, chest pain, shortness of breath, diaphoresis, or focal neurological symptoms. Upon exam, you find: General: Alert and oriented X 3, sitting fully dressed in a chair Lungs: CTAB Cardiovascular: RRR without murmur, rub, or gallop Abdomen: Soft and NT, no pulsatile mass Ext: No peripheral edema, pulses are 2+ and equal in all extremities …
Read More
Case The patient is a 25-year-old man who presents with pain in his shoulder after falling from a ladder while cleaning out the gutters of his grandparents’ home. 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. Figure 1.
Read More
Case The patient is a 45-year-old woman who presents after experiencing chest pain for the past 2 hours. She has some minimal dyspnea, but no diaphoresis. She takes birth control pills and is a smoker. She denies family history of cardiac disease. 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 Ext: No peripheral edema or calf pain, pulses 2+ and …
Read More
Case The patient is a 51-year-old man who presents to urgent care complaining of a persistent cough. He reports it started “about a month ago,” but his wife, who is with him, insists it’s been at least 6 weeks. 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.
Read More
Figure 1. The patient is a 41-year-old woman who presents with wrist pain and swelling after falling on her outstretched hand in ulnar deviation. She says she stumbled stepping into the house while carrying groceries. View the image taken and consider your next steps, along with possible diagnoses.
Read More
Case A 35-year-old, HIV-infected patient who recently started highly active antiretroviral therapy (HAART) presents to your urgent care center very concerned about a large group of vesicles that had appeared on her leg. She recalls feeling a burning sensation for several days before they appeared. Upon probing, she tells you that she’s also had headache, neck pain, and fatigue. View the photo and consider what your diagnosis and next steps would be. Resolution of the …
Read More
Case The patient is a 74-year-old man who complains of epigastric pain. He is an alcoholic who has had multiple episodes of pancreatitis. He has no chest pain, shortness of breath, or diaphoresis. An ECG is performed by staff prior to provider evaluation. 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 and consider …
Read More
Case A 51-year-old woman presents with wrist pain and swelling after tripping on a loose piece of carpeting and falling on her outstretched hand. 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.
Read More
Figure 1. The patient is a 32-year-old woman who presents with ankle pain following a fall in which she twisted her ankle. She reports that she was texting while walking her dog and stumbled off the curb. View the image taken and consider your next steps, along with possible diagnoses.
Read More