A Patient on Dialysis with Syncope

History:  A 67-year-old female presents to urgent care complaining of one episode of syncope earlier in the day. No seizure-like activity was noted by the family and she returned to baseline within a minute. She has a past medical history of end-stage renal disease on scheduled hemodialysis, hypertension, diabetes, coronary artery disease, and chronic nausea. Medications include aspirin, insulin, amlodipine, hydralazine, ondansetron, metoclopramide, and amiodarone.               View the ECG taken and consider what your diagnosis …

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A 36-Year-Old Man with Wrist Pain After a Traumatic Impact

A 36-Year-Old Man with Wrist Pain After a Traumatic Impact

The patient is a 36-year-old man who presents with wrist pain after “hitting it on something.” Further history reveals that he punched a wall in a fit of anger and felt sharp pain immediately.  He has no past medical history and takes no medications. View the images 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 46-Year-Old Woman with a Painful, Erythematous Plaque on Her Leg

A 46-Year-Old Woman with a Painful, Erythematous Plaque on Her Leg

The patient is a 46-year-old female who presents with a painful, erythematous, indurated plaque on her lower leg. She reports that it developed over the past month. At first she attributed the pain to “a bump” of unknown origin, but as the area of red skin expanded she became concerned that she became concerned, as she reports a history of deep-vein thrombosis.               View the image taken and consider what your diagnosis and next steps …

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A 34-Year-Old Female with a Syncopal Episode but No Remarkable History

A 34-Year-Old Female with a Syncopal Episode but No Remarkable History

A 34-year-old female with no reported medical history presents to urgent care after a syncopal episode. She describes standing up rapidly to answer the phone, followed by a sensation of lightheadedness and nausea with subsequent collapse. On evaluation, her vital signs are normal, she appears well, and she is currently asymptomatic. View the ECG taken and consider what your diagnosis and next steps would be. (Case presented by Tom Fadial, MD, The University of Texas …

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