Practice Management
A 24-year-old male patient presents to urgent care with right wrist pain that started while playing golf 2 days ago. The patient recalls swinging the club and hitting the ground rather than the ball, felt a sharp pain in his hand which has been constant since the incident. He has not tried any treatments at home. The provider notes increased pain when the patient flexes his hand, along with a weakened grip compared to the …
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A 60-year-old male presents to urgent care with progressive dyspnea for 2 weeks associated with lower extremity edema. The patient is afebrile and slightly tachypneic with rales at the bilateral bases. An ECG is obtained. View the ECG 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 28-year-old female presents to urgent care with mild left lower quadrant (LLQ) abdominal pain that began earlier in the day. The discomfort is dull, intermittent, and non-radiating. She denies vaginal bleeding, fever, nausea, vomiting, or urinary symptoms. Her last menstrual period was approximately 2 months ago, although she reports a history of irregular cycles. She appears well and is hemodynamically stable. An abdominal exam reveals mild LLQ tenderness without rebound or guarding. A pelvic …
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A 75-year-old male presents to the walk-in clinic with the chief complaint of an asymptomatic rash on the left temple of his face that developed over the past 2 months. On examination, a shiny deep red papule is visible with scaly macules (actinic keratoses) surrounding. The patient is on rituximab for chronic lymphocytic leukemia (CLL). View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described …
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An 11-year-old male presents to urgent care complaining of bilateral heel pain, right worse than left. The patient denies recent trauma and reports experiencing increased pain when running. He has not tried any treatment and denies any history of similar episodes in the past. Physical examination reveals bilateral pes planus and decreased dorsiflexion of the feet with weightbearing lunge against the wall. Pain is elicited with calcaneal compression test. The patient is noted to be …
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An 80-year-old male with hypertension and hyperlipidemia presents to urgent care for 1 day of sharp, substernal chest pain radiating to his right arm with associated shortness of breath and diaphoresis. His wife notes that he is often nonadherent with his medications. An ECG is ordered. View the ECG 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 42-year-old woman with widespread scaly lesions presents to urgent care. On exam, the provider noted superficial crusts and exfoliative plaques seen on the face, neck, and chest. The patient reported that the lesions were painful, but she had no systemic symptoms and felt fine otherwise. The rash emerged a couple of months prior. The patient had no recent history of travel or infections and was not currently on any medications. The urgent care took …
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A 42-year-old man presents to urgent care on a Sunday afternoon. He explains that he was playing a game of pick-up football in his neighborhood and suffered a rough kick to the face from another player. His nose is swollen, and he’s clearly in pain. An x-ray is ordered to capture a lateral view of the nasal bones. Review the image and consider what your diagnosis and next steps would be. Resolution of the case …
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A 56-year-old female with no past medical history presents to urgent care with 2 episodes of chest pain that woke her up this morning. She had 2 additional episodes while walking and while bathing earlier in the day. The episodes lasted about 10 minutes each, and she is currently free from chest pain. The pain is pressure-like and left-sided, radiating to her back. An ECG is obtained. View the ECG and consider what your diagnosis …
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A 3-week-old girl presents to urgent care with widespread scaly skin. On physical examination, her vital signs are normal. She is noted to have ectropion and large, thick, plate-like scales covering most of her body. The patient had a personal history of prematurity and collodion membrane at birth. There is no family history of dermatological or genetic disorders. View the image below and consider what your diagnosis and next steps would be. Resolution of …
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