Practice Management
The patient is a 75-year-old female who presents with dizziness and a slow heartbeat. She has a history of hypertension. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case begins on the next page.
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A 49-year-old woman presents with a lesion that developed over her right toe over the past 4 weeks. It is painless, but has begun to bleed. On examination, a smooth, pink, friable, eroded nodule is seen on the nail bed. 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 69-year-old man presents with “neck pain” after a car crash. Lateral and oblique views of the lower cervical spine are ordered. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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The patient is a 55-year-old woman who presents with sudden-onset wrist pain in her right wrist. She reports that she is right-handed and played pickleball the day before onset, and that she is an avid bicyclist, but denies falling or experiencing any pain in the course of those activities. She says she “just woke up with it hurting.” View the image taken and consider what your diagnosis and next steps would be. Resolution of the …
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A 17-year-old high school lacrosse player presents to an urgent care center with a painful left ankle. He states that the pain started 2 days earlier when he twisted his left ankle (an inversion injury) while competing in a tournament. He says that he tried to continue to play, but the pain increased. He reports that the ankle swelled over the lateral aspect and that he has pain when he walks. He says that he …
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A 67-year-old male presents to urgent care complaining of pleuritic chest pain and dyspnea. He has a history of lung cancer, but denies known cardiac history. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is describe on the next page.
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A 23-year-old woman presents with a severely pruritic rash that developed on her leg and is spreading. The patient reports that 2 days prior to onset, she had gone hiking with her dog. She recalls going off-trail and brushing up against “woody vines and shrubs.” She denies sustaining insect bites and notes that the sun was particularly intense that day, so she wonders if this may be a sun reaction. She appears well and has …
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Download the article PDF: A 45-Year-Old with Chest Deformity A 45-year-old man presents with “asthma-like symptoms” that he says have “come and gone” for several years. He denies chest pain or a sense of racing heartbeat. A chest deformity is clear from observation. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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Download the article PDF: A 30-Year-Old Male with Chest and Leg Pain—and a History of Polysubstance Use A 30-year-old male with history of polysubstance use presents after a motor vehicle collision. He reports chest and leg pain, and denies nausea, vomiting, or shortness of breath. He has no known cardiac history. View the ECG 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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Download the article PDF: A 59-Year-Old with a Painful Finger Skin Lesion A 59-year-old woman presents with a painful skin lesion near her fingernail which has developed over the past week. She reports a history of advanced non-small cell lung cancer, for which she was recently started on erlotinib. On examination you observe a glistening, hemorrhagic papule at the lateral nail fold with surrounding erythema and edema. The patient denies trauma or exposure to skin …
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