Practice Management
On a Friday afternoon, a worried mother brings her 4-year-old daughter to the urgent care. She says the girl is complaining that her “side hurts.” The mother can’t recall any recent falls or injuries. Review the image of the anterior to posterior (AP) pelvis taken upon presentation and consider possible diagnoses and next steps you would recommend to the family.
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The patient is a 75-year-old female who presents with dizziness and a slow heartbeat. She has a history of hypertension. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case begins on the next page.
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A 49-year-old woman presents with a lesion that developed over her right toe over the past 4 weeks. It is painless, but has begun to bleed. On examination, a smooth, pink, friable, eroded nodule is seen on the nail bed. View the image 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 69-year-old man presents with “neck pain” after a car crash. Lateral and oblique views of the lower cervical spine are ordered. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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A 67-year-old male presents to urgent care complaining of pleuritic chest pain and dyspnea. He has a history of lung cancer, but denies known cardiac history. View the ECG taken and consider what your diagnosis and next steps would be. Resolution of the case is describe on the next page.
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A 23-year-old woman presents with a severely pruritic rash that developed on her leg and is spreading. The patient reports that 2 days prior to onset, she had gone hiking with her dog. She recalls going off-trail and brushing up against “woody vines and shrubs.” She denies sustaining insect bites and notes that the sun was particularly intense that day, so she wonders if this may be a sun reaction. She appears well and has …
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Download the article PDF: A 30-Year-Old Male with Chest and Leg Pain—and a History of Polysubstance Use A 30-year-old male with history of polysubstance use presents after a motor vehicle collision. He reports chest and leg pain, and denies nausea, vomiting, or shortness of breath. He has no known cardiac history. View the ECG 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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Download the article PDF: A 59-Year-Old with a Painful Finger Skin Lesion A 59-year-old woman presents with a painful skin lesion near her fingernail which has developed over the past week. She reports a history of advanced non-small cell lung cancer, for which she was recently started on erlotinib. On examination you observe a glistening, hemorrhagic papule at the lateral nail fold with surrounding erythema and edema. The patient denies trauma or exposure to skin …
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A 41-year-old male presents with knee pain after playing basketball in his driveway with his teenage son. He reports that he had sudden pain and heard a “pop” as he landed after jumping. He is unable to fully extend his leg. View the image taken and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.
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Figure 1: Initial ECG (Case presented by Benjamin Cooper, MD, MEd, FACEP, Department of Emergency Medicine, McGovern Medical School at UTHealth Houston.)
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