Light Exercise and mTBI Asymptomatic Hypertension—What’s the Risk? Racial Factors in Pain Treatment Supplemental Oxygen in ACS Shorter Courses of Antibiotics for Pediatric CAP Who’s Behind that COVID-19 Mask? COVID-19 Infection in Healthcare Workers Light Exercise for Patients with Mild Traumatic Brain Injury (mTBI) Take-home point: There is no benefit for recovery in patients with mTBI randomized to light exercise compared with standard care. Citation: Varner C, Thompson C, de Wit K, et al. A …
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A 32-Year-Old Male with Pain After Dropping a 20-Pound Weight on his Finger
The patient is a 32-year-old man who presents with pain over the distal phalanx of the middle finger after dropping a 20-pound weight on his finger while constructing a home gym set-up. The skin is unbroken, but pain is evident upon palpation over the distal phalanx of the middle finger. Neurovascular status is intact. View the image taken (Figure 1) and consider what your diagnosis and next steps would be. Resolution of the case …
Read MoreA Patient on Dialysis with Syncope
History: A 67-year-old female presents to urgent care complaining of one episode of syncope earlier in the day. No seizure-like activity was noted by the family and she returned to baseline within a minute. She has a past medical history of end-stage renal disease on scheduled hemodialysis, hypertension, diabetes, coronary artery disease, and chronic nausea. Medications include aspirin, insulin, amlodipine, hydralazine, ondansetron, metoclopramide, and amiodarone. View the ECG taken and consider what your diagnosis …
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A 36-Year-Old Man with Wrist Pain After a Traumatic Impact
The patient is a 36-year-old man who presents with wrist pain after “hitting it on something.” Further history reveals that he punched a wall in a fit of anger and felt sharp pain immediately. He has no past medical history and takes no medications. View the images 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 60-year old Male with Dyspnea and Hypoxemia at the Start of a Global Pandemic
Urgent message: The identification and global impact of the novel coronavirus has significantly challenged medical decision-making. Urgent care providers now consider the inclusion of the SARS-CoV-2-causing illness in their differential diagnosis when evaluating patients with signs and symptoms of an acute respiratory infection. Louis Costanzo, MD, MBA Introduction As of March 2021, there have been more than 28.6 million documented cases of COVID-19 in the United States, with the majority of cases those ages 18 …
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Neuro Effects of COVID-19 Melatonin and Children with Postconcussive Symptoms Pediatric, Sports-Related Concussion Acute Migraine in Children and Adolescents Emily Montgomery, MD and Kelsey Riggs, MS3 Neurologic Manifestations of COVID-19 Take-home point: COVID-19 has a variety of presentations that include neurologic manifestations—most commonly, headaches. Citation: Niazkar HR, Zibaee B, Nasimi A, Bahri N. The neurological manifestations of COVID-19: a review article. Neurol Sci. 2020 Jul;41(7):1667-1671. Relevance: More than 1/3 of patients with COVID-19 experience neurologic …
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Outpatient Management of COVID-19 in the Urgent Care Clinic: Administering Monoclonal Antibodies
Urgent message: The approved use of monoclonal antibodies to treat patients who have COVID-19 may signal a shift from inpatient to outpatient care of infected individuals who do not require hospitalization. Urgent care facilities may be ideally suited to serve as treatment centers and to become destinations of choice for such patients. Lindsey Fish, MD Now that COVID-19 has been with us for over a year, we are in a much different position regarding the …
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Pretravel Consultations in the Urgent Care Setting
Urgent message: A pretravel consultation assesses the patient’s fitness for travel in the context of anticipated risks associated with their journey. This individualized counseling takes into account not just age or destination, but also general health and other factors such as past travel experience. Given the proliferation of single-specialty travel medicine clinics, with appropriate training and preparation, these assessments can easily be performed in the urgent care setting. Benjamin Silverberg, MD, MSc, FAAFP, FCUCM Citation: …
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A 28-Year-Old Boxer with Wrist Pain After a Bout
The patient is a 28-year-old male with right wrist pain after a boxing match. He reports that he felt “a pop” and immediate pain along the ulnar aspect of his wrist after throwing a punch. He has no past medical history and takes no medications. View the x-ray 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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Managing Concussions in Acute Care
Jordan Wackett MD, MPH, Joshua Kornegay, MD, Craig Rudy, MD The most recent recommendation from the Concussion in Sport Group calls for 24-48 hours of rest and a graded return to activity (unrestricted once asymptomatic)2. Unfortunately, asymptomatic from a concussion standpoint is not always obvious, which can make the new recommendation difficult to implement as patients may remain symptomatic while adhering to rest. Symptomatology is often multifactorial and they may be instructed to rest despite …
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