Practice Management
A 28-year-old female presents to urgent care complaining of right ankle pain after awkwardly stepping off a high curb, subsequently rolling her ankle while running outside earlier today. She is unable to bear weight on her ankle. She has no past medical history, takes no medications regularly, and has not tried any treatments since the injury. Physical exam reveals she is afebrile with normal vital signs, and she has marked tender edema to the lateral …
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A 63-year-old woman visits urgent care with the chief complaint of an asymptomatic scabby growth on her scalp that developed 10 months prior and is gradually getting larger. The patient has no systemic symptoms and is otherwise well. She has a history of working as a welder in a metal fabrication plant for the past 35 years. On dermatological examination, an eroded and crusted plaque is seen on the frontal scalp. A punch biopsy reveals …
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A 28-year-old male with history of left shoulder dislocations presents to urgent care with severe left shoulder pain. He reports an inability to move the arm after injuring his shoulder while taking off his shirt. He reports feeling the shoulder “shift out of place” during the movement. On examination, the patient is in significant discomfort. He is holding the left arm in slight abduction with left shoulder external rotation. His elbow is flexed and his …
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A 12-year-old male presents to urgent care with his mother for left groin and buttock pain since acute onset while running in a track meet earlier today. He reports that he felt a pop while running a sprint race and was subsequently unable to finish the race or bear weight on his left leg due to pain. He has no other past medical history and takes no medications. Physical exam reveals that he is afebrile …
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A 39-year-old male presents to the local urgent care reporting an intensely itchy rash for the past 3 weeks that is getting gradually worse. The patient has a history of HIV infection, denies any recent travel or trauma, and is not taking any medications. Physical exam shows he is afebrile with normal vital signs. He has diffuse papular lesions to the trunk and arms ranging from pink to dark brown in color, some with notable …
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The family of a 42-year-old male brings the patient to urgent care for altered mental status believing that they had arrived at an emergency department. His family found him on the floor at home with a non-functioning heater on a very cold day. He is bradycardic and ill-appearing. An ECG is obtained.
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A 26-year-old female presents to urgent care with a persistent productive cough for 1 week. Over the past 3 days, she reports progressive shortness of breath and fatigue. She has a history of recurrent pneumonia. Vital signs show the patient is afebrile with normal blood pressure, heart rate, respiratory rate, and oxygen saturation. Physical examination revealed clear lung sounds with diminished air movement in the bilateral bases. Jugular venous distension (JVD) at 4 cm above …
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A 67-year-old man visits urgent care for a lesion on his right ankle that was first noticed 25 years ago. He reports that it has progressively grown larger over the past 6 months. The lesion is painless but is intermittently mildly pruritic. The patient denies any recent injury or past medical history besides chronic venous insufficiency. On dermatologic examination, a discrete dark brown plaque is noted posterior to the lateral malleolus with numerous surrounding spider …
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An 84-year-old woman presents to urgent care with palpitations that have lasted for several hours. The patient is afebrile, slightly tachypneic on exam, with a blood pressure of 148/97 mm Hg. 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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