Case This 42-year-old woman presents to your urgent care center with a 2-hour history intermittent dizziness and vomiting. She denies diarrhea or exposure to ill persons. Further history reveals that she has recently had some epigastric discomfort. In the exam room, she is alert and oriented. She seems comfortable, in fact. In addition, you find: Lungs: Minimal bilateral symmetric wheezing Cardiovascular: Regular rate and rhythm without murmur, rub, or gallop Abdomen: Soft and nontender without …
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A 37-Year-Old Man with a Two-Day History of Chest Pain
The patient is a 37-year-old man who reports a two-day history of chest pain. It worsens with exertion, and when he lays back; it improves when he’s sitting or leaning forward. He denies any diaphoresis, radiation, or back pain. No pleuritic aspect. During the exam, he is alert and oriented, and in no distress. In addition, you find: Lungs: Clear to auscultation bilaterally Cardiovascular: Regular rate and rhythm without murmur, rub, or gallop Abdomen: Soft …
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A Female with Coccyx Pain
A 48-year-old woman presents with lower sacral and coccyx pain one day after a fall in which she says she simply “missed” the edge of a chair and landed on the floor at a party. View the images taken and consider your next steps, along with possible diagnoses.
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Elbow Pain and Swelling After a Fall
Case A 28-year-old woman presents to urgent care with elbow pain and swelling following a mechanical fall. She reports the pain is worse with range of motion. There is no shoulder or wrist pain, and no paresthesias. Exam confirms pain with palpation and decreased range of motion. The radial pulse is 2+; sensation distal to the elbow is grossly intact. The patient is afebrile, has a pulse of 104, respirations 20, and BP 124/80. View …
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Suddenly Urgent Chronic Hip Pain
A 47-year-old male presents to your urgent care center with an exacerbation of chronic hip pain. The patient offers little by way of explanation; he reports he’s felt discomfort in his right hip “for years,” but that it’s grown worse recently. View the images taken and consider your next steps, along with possible diagnoses.
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Dull, Constant Back Pain After a Fall: Abdominal Aortic Aneurysm (AAA)
Case A 67-year-old male presents with acute mid-low back pain following a fall. He describes the pain as “dull and constant.” When asked if the pain is worse with range of motion, he replies, “I think so.” Physical exam reveals he is afebrile, has a pulse of 102, respirations 20, and blood pressure 122/78. His abdomen is soft and nontender without rigidity, rebound, or guarding; there is no bruising or distention. His back appears normal, …
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Back Pain After Falling from a Ladder
A 21-year-old male presents to your urgent care center complaining of back pain after falling from a ladder. He is unclear about the exact point of impact, but the pain increases with attempts to bend or twist. Examination reveals he has decreased range of motion. View the image taken (Figure 1) and consider your next steps, along with possible diagnoses.
Read MoreGlass in Foot
Case The patient is an 8-year-old boy with pain in the right foot for the last several hours. He refuses to walk on the foot. There is no reported injury. On physical exam, you find there is a normal appearance to the foot (no erythema, swelling). However, there is pain with palpation over the plantar aspect of the mid aspect of the right foot. View the image taken (Figure 1) and consider what your diagnosis …
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Irregular Skin Patch on a 16-Year-Old Boy
A 16-year-old presents with an irregular patch of skin on his chest, reporting that it has become increasingly hyperpigmented over the past year. He also says the same area has had in increase in hair growth in recent months View the image taken (Figure 1) and consider what your diagnosis would be.
Read MoreLateral Humeral Condyle Fracture
Case A 14-year-old boy presents to urgent care complaining of lateral right elbow pain that began after a fall on the playground yesterday, in which he landed on his outstretched hand. He has no significant medical or surgical history. The elbow pain is worse with range of motion. He denies any wrist or shoulder pain, and there is no head trauma. There are no paresthesias to the hand or arm. View the images taken (Figures …
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