Practice Management
A 35-year-old woman presents with a 5-day history of worsening abdominal pain and several days of “constipation.” Review the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
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Urgent message: Lisfranc dislocations are relatively rare, but should be on the urgent care provider’s radar in patients who refuse to bear weight and who have significant midfoot pain and swelling after an acute trauma causing hyperplantarflexion of the foot. Introduction The tarsometatarsal (TMT), or Lisfranc, joint complex is the attachment between the forefoot and midfoot. This joint is the keystone to normal foot function and is thus critical for normal gait.1 Jacques L. Lisfranc …
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The patient is a 22-year-old woman who presents complaining of frequent nosebleeds. On exam, you note bright red macules and spider veins on her lips and tongue. They disappear briefly when you press on them. Review the image below and consider what your diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreGeneral Statistics of COVID-19 Clinical Characteristics of COVID-19 Characteristics of Healthcare Workers Infected with COVID-19 A Simple Algorithm for Treatment of Nonpurulent Infections Topical Lidocaine for Oral Ulcers in Children Walking Boot vs Rigid Cast in Achilles Tendon Rupture General Statistics of COVID-19 Key Point: The majority of patients with COVID-19 have mild symptoms; however, those with critical disease have a mortality rate of 49%. Citation: Wu Z, McGoogan JM. Characteristics of and important lessons …
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The patient is a 38-year-old man who presents with an exacerbation of chronic shoulder pain. He can’t recall when the pain initially started, but reports that it began to get worse after he played tennis for the first time this season, about a week ago. View the image taken and consider your next steps, along with possible diagnoses.
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The patient is a 55-year-old woman who presents with what she calls minor pain in her left hip. She denies any trauma, and insists the pain “isn’t that bad.” She’s only seeking care as a precautionary measure in advance of a family camping trip. View the image taken and consider what the diagnosis and next steps would be. Resolution of the case is described on the next page.
Read MoreCOVID-19: The Long View Quarantine Duration in Suspected COVID-19 Bedside Ultrasound Use with COVID-19 Fluoroquinolones and Arrhythmia Isopropyl Alcohol and Nausea Relief Patient Preferences Re: the ED vs Urgent Care The Nuts and Bolts of COVID-19 Key Points: Most patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19 experience mild URI symptoms; however, the virus tends to cause disproportionately severe illness in older and chronically ill adults. Treatment is only …
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Urgent message: While skin-related complaints are not uncommon in the urgent care setting, with psoriasis being a relatively common source, evaluation and diagnosis of a rash can be challenging. This is especially true in the case of a rare variant like guttate psoriasis. Chasity L. Falls, MS, PA-C INTRODUCTION Psoriasis is a common condition. However, the guttate variant is rarer, commonly affecting children and young adults less than 40 years of age and accounting for …
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Urgent message: Efforts to have pain declared a “fifth vital” sign began nearly 25 years ago. Since then, several national accrediting and governmental agencies have taken up the cause of viewing pain as a distinct problem to be addressed as such. However, few data relevant to emergency and urgent care presentations exist. Mark Pruitt, DO, Ya Wen, DO, Michael Pallaci, DO, and Godwin Dogbey, PhD INTRODUCTION Traditionally, there have been four vital signs: temperature, …
Read MoreLong before the first flowers of the new year bloom, an even earlier indicator of winter’s end manifests itself: teenagers plotting and perseverating over Spring Break plans. Partially a rite of passage and in other ways an early indicator of a youth’s future fate, much can be predicted about an adolescent’s trajectory by their choice of destination and activity during this vernal vacation. Sure, it’s not a perfect science. However, it’s safe to say that …
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