Clinical Challenge 3: October 2017

Clinical Challenge 3: October 2017

A 40-year-old woman visits your urgent care center several days after first noticing a rash of pruritic smooth papules on her trunk and intertriginous areas. She reports that she had been spending a lot of time in the pool with her children before they returned to school. Now she also has a fever and swollen glands, and complains of general malaise. View the photo and consider what your diagnosis and next steps would be. Resolution …

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Clinical Challenge 2: October 2017

Clinical Challenge 2: October 2017

A 42-year-old woman with a history of anxiety presents, complaining of intermittent palpitations over the past 2 weeks. She says she has not taken any medication and denies chest pain, shortness of breath, diaphoresis, fever, or dizziness. Upon exam, you find: General: Alert and oriented X 3 Lungs: Clear to auscultation bilaterally Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, or guarding Extremities: No pain or swelling, …

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Clinical Challenge: October 2017

The patient is a 25-year-old male who presents with pain over the distal phalanx of the middle finger. He says he hit it with a hammer while hanging a picture frame in his new apartment a short while ago. Pain is evident upon palpation over the distal phalanx of the middle finger, but there are no cuts or breaks in the skin. Neurovascular status is intact. View the image taken (Figure 1) and consider what …

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A 35-Year-Old Man with Pain After Punching a Wall

A 35-Year-Old Man with Pain After Punching a Wall

A 35-year-old male presents to urgent care complaining of pain over the metacarpal of the little finger after punching a wall in his home for reasons he chose not to explain. On exam, pain is evident with palpation at the base of the metacarpal. You note there is a deformity over the 5th metacarpal bone. The neurovascular status is intact. View the images taken and consider your next steps, along with possible diagnoses.

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A 30-Year-Old Woman with a ‘Burning’ Tongue

Case A 30-year-old woman visited urgent care complaining of a burning sensation on her tongue. At first, she had blamed it on a spicy meal, but the feeling didn’t go away and now she feels as though she isn’t able to taste food as usual. Looking back, she recalls that over a month ago she noticed a white plaque on her tongue. However, that had had disappeared within a day so she hadn’t thought much …

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A 73-Year-Old Man with a 2-Week History of Palpitations

A 73-Year-Old Man with a 2-Week History of Palpitations

Case The patient is a 73-year-old male smoker who complains that he has had intermittent palpitations for the past 2 weeks. He denies chest pain, diaphoresis, fever, or dizziness. He uses home oxygen, 2 L/min, but denies any new shortness of breath. Upon exam, you find: General: Alert and oriented x 3 Lungs: Scattered minimal wheezing, which is symmetric Cardiovascular: Regular and tachycardic without murmur, rub, or gallop Abdomen: Soft and nontender without rigidity, rebound, …

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A 21-Year-Old Male with Foot Pain

A 21-Year-Old Male with Foot Pain

Case A 21-year-old male presents with pain after dropping a piece of furniture on his right foot. He is physically able to bear weight during the assessment, though his pain is evident and he is unsteady when shifting his weight to the injured foot. 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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A 51-Year-Old Man with Wrist Pain After a Fall

A 51-Year-Old Man with Wrist Pain After a Fall

A 51-year-old male presents to urgent care with wrist pain after stumbling while walking his dog. He recalls landing on his outstretched arm. On exam, there is pain with palpation, and decreased range of motion of the distal wrist. Neurovascular status is intact, and there are no breaks in the skin. View the image taken and consider your next steps, along with possible diagnoses.

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A Middle-Aged Man with Several Weeks of Midfoot Pain

A Middle-Aged Man with Several Weeks of Midfoot Pain

A new patient—a 45-year-old man who says he’s been plagued by midfoot pain for several weeks—presents to your urgent care center. The foot is normal in appearance, but it is evident that the patient has pain palpation over the midfoot. There is no pain with palpation over the plantar aspect. Skin does not show signs of infection. The neurovascular status is intact. View the image taken and consider your next steps, along with possible diagnoses.

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An 18-Year-Old Woman with Sudden Rash, Vomiting, and Cramping

Case An 18-year-old woman was swimming in the Atlantic Ocean off the coast of Florida when suddenly she experienced a sharp, stinging pain on her arm. That evolved into a severe ache shortly, accompanied by a painful red lesion. She vomited on her way to your urgent care center, and still feels nauseous. She is also complaining of muscle cramps. View the photo and consider what your diagnosis and next steps would be. Resolution of …

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