Practice Management
Urgent message: Chest pain in young adults is often benign but it’s important to always consider conditions that increase risk of cardiovascular disease when evaluating these patients. RAFAEL ILYAYEV, MD, FACP, MOHAMED A. MOHAMED, MD, AND HASSAN FARHAT, MD Overview This case illustrates the importance of considering and ruling out rare causes of coronary artery disease (CAD) in young patients who present with chest pain. One of these rare causes is a hypercoagulable state secondary …
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Urgent message: Visceral injury is possible in association with the seemingly minor trauma seen in urgent care, underscoring the importance of remaining alert for “red flag” signs and symptoms and judiciously using advanced diagnostics. Introduction Blunt abdominal trauma occurs in 10% to 15% of injured children.1 History and specifically mechanism of injury, and physical exam are important when a patient presents to the clinic with a suspected blunt abdominal trauma. Usually, injuries to the intra-abdominal …
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Urgent message: Patients with seemingly unusual conditions do present to urgent care, underscoring the need to always take a thorough history for all “red flag” symptoms. LEE A. RESNICK, MD, FAAFP Introduction While the incidence of acute rheumatic fever has declined significantly in developed countries over the last several decades, sporadic cases do still occur. Diagnosis may be difficult due to the non-specific symptoms and the lack of experience with the condition amongst most urgent …
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Urgent message: The key to this case was in the details of the presenting symptoms in the patient history: Alarm symptoms including extreme fatigue and weight loss, which warranted further diagnostic work up. ABRAR KHAN, MD, MBA, REVATHY NAIR, MD, and MARIANN MELICHAREK, MD, FACEP Introduction Sarcoidosis is a multisystem granulomatous disorder of unknown etiology. Most patients with sarcoidosis present to urgent care providers with symptoms such as cough, dyspnea, chest pain, eye pain and/or …
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Urgent message: With the epidemic of obesity and recent FDA-approval of weight loss drugs, urgent care providers should be on alert for patient presentations related to side effects of these agents. Introduction An estimated 154.7 million Americans over the age of 20 are currently overweight or obese. These Americans are at increased risk of disease, including diabetes mellitus, cardiovascular disease, end-stage renal disease and cancer. If current trends remain unchanged, an estimated $861 to $957 …
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Urgent message: Each case—and patient presentation—in urgent care must be evaluated on its own merits. Rare diagnoses are possible and “benign” back pain complaints sometimes are not. HEATHER VARLEY, PA-C, and WILLIAM GLUCKMAN, DO, MBA, FACEP Introduction Each day in the urgent care setting, we are presented with a range of various pain complaints, from headaches, to back pain, to extremity pain. These complaints may be the result of injury, overuse, infection, arthropathy, or have …
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Urgent message: The use of dilute proparacaine appears to be a safe and cost-effective way to treat the pain associated with many acute corneal injuries. JACQUALINE DANCY, PA-C, MPAS Editor’s Note: This article deviates from our typical case report format to underscore one of the key points for management of eye conditions discussed in this month’s cover story. Introduction Ocular injuries are often painful and can cause significant suffering. Many medical practitioners provide immediate, but …
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