A 70-Year-Old Man with Hand Numbness and Pain

A 70-Year-Old Man with Hand Numbness and Pain

The patient is a 70-year-old male who presents to urgent care with numbness, pain, and difficulty opening his hands. His son, who drove his father to the appointment, notes that the skin also looks “bunched up in places.” The physician also observes what look like raised scars. The thumb and index finger seem unaffected. Upon questioning, the patient says he started noticing smooth nodules “a couple years ago.” He attributed that to his many years …

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Urgent Identification and Management of Postsplenectomy Sepsis

Urgent Identification and Management of Postsplenectomy Sepsis

Urgent message: Asplenic individuals have a rate of severe infections 2-3 times higher than the general population. Postsplenectomy sepsis should be considered in patients with impaired splenic function who present with a fever. Megan L. Lawson, PA-C and Christina Gardner, DHSc, MBA, PA-C CASE PRESENTATION A 45-year-old male presented to the urgent care with 18 days of sinus pain and congestion unresponsive to two courses of antibiotics, cefdinir and levofloxacin. Past surgical history revealed a …

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A Blistering Rash in an Otherwise Healthy 9-Year-Old Boy

A Blistering Rash in an Otherwise Healthy 9-Year-Old Boy

Urgent message: Impetigo is one of the most common skin infections in children, and can have a variable presentation. As such, it is essential that the urgent care provider be able to recognize this common skin infection, and to know the treatment options. Aimy T. Patel, MD, FAAP, Allison Burris, MD FAAP, and Nirav Shastri, MD, FAAP, FAMIA, ABMS-CI CASE PRESENTATION History A 9-year-old otherwise healthy boy presents with a 1-week history of an itchy …

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Keep Your Differential Broad, Especially During Flu Season

I’m phenomenally bad at gambling for a multitude of reasons. I bet small when I should bet large. I bet large when I shouldn’t even be playing the game. I’m especially terrible at roulette because when I pick a number, usually 22, I stick with it—much longer than I should. Each time the wheel stops, on any other number, I’m disappointed, sure. But that disappointment is quickly replaced with hope that the odds of lucky …

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Evaluation and Diagnosis of Trigger Finger with Current Management Strategies

Urgent message: Appropriate treatment of “trigger finger” in the urgent care setting starts with differentiating that diagnoses from other disorders of the hand. This is relatively straightforward if one finger is involved, but can become more complex with multiple digits. Shailendra K. Saxena, MD, PhD and Alexander M. Stock, BS INTRODUCTION Trigger finger, also known as stenosing flexor tenosynovitis, is a common hand disorder that affects approximately 2.6% of the general population during their lifetime.1 …

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A 69-Year-Old Man with a 2-Month History of Shortness of Breath and Mild Chest Pain

A 69-Year-Old Man with a 2-Month History of Shortness of Breath and Mild Chest Pain

The patients is a 69-year-old man with shortness of breath and mild chest pain of 2 months duration. He has felt it unnecessary to see his “regular doctor” because his complaints haven’t gotten worse, but conceded to visit urgent care today at the insistence of his family. When asked, he acknowledges a history of congestive heart failure and hypertension. View the ECG and consider what your diagnosis and next steps would be. Resolution of the …

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Abstracts in Urgent Care Medicine

Abstracts in Urgent Care Medicine

Topical TXA vs Merocel in anterior epistaxis Cool Running Water Reduces Need For Skin Graft In Pediatric Burns  Efficacy Oral Ibuprofen at Various Doses for Short-Term Pain Relief Do Patients Know What Fracture Means? Tramadol’s Numerous Adverse Drug Reactions Recurrent Febrile Seizures Increase Morbidity And Mortality Yijung Russell, MD Topical TXA Is as Effective as Merocel in Stopping Anterior Epistaxis  Key point: Atomized TXA with nasal compression is as effective as Merocel in stopping anterior …

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Abstracts in Urgent Care – January 2020

The FDA on Cannabidiol Improving Diagnosis of Cluster Headache Making Tympanostomy Tube Placement Office-Friendly Nothing to Fear from NDMA? Counseling Patients on Preventing Cardiovascular Disease FDA Delves Deeper into Use of CBD Products Key point: The FDA is working to answer questions about the science, safety, and quality of products containing cannabis and cannabis-derived compounds, particularly CBD. Citation: U.S. Food & Drug Administration. What you need to know (and what we’re working to find out) …

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A New Year, and a New Era for JUCM

35,000. As I assume the role of editor-in-chief of the journal, this is the number that revolves through my head with rhythmic pops like an old, vinyl record. Cognitive psychologists estimate that that’s the number of decisions an average adult makes every day. This number may seem impossibly large at first, to the point of absurdity even. After all, that breaks down to a decision every 2 seconds. But let’s pause briefly and examine this. …

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