Practice Management
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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A 53-year-old male butcher visits urgent care for a painful red rash that developed on his hand 3 days prior. There is no history of recent travel, but he accidentally cut himself when processing meat 1 week ago. Exam reveals that the patient is febrile at 100.2° F. Otherwise, his vital signs are within normal limits, and he is well appearing. On dermatologic examination, erythematous vesiculated papules, plaques, and associated edema are visible on the …
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A 55-year-old male with past medical history of alcohol use disorder presents to urgent care with frequent falls. He denies chest pain or shortness of breath. 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 7‑year‑old male presents to the urgent‑care clinic with left‑knee pain that began after gym class and has gradually worsened over the past several weeks. The mother reports no significant trauma and notes that the pain improves with rest. Physical examination reveals a slightly overweight child with a visible bowing deformity just distal to the knee. The patient demonstrates a full range of motion and normal knee strength, and no bony tenderness, effusion, or laxity …
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