Acute Appointments Are Never Quite What They Seem

I've been seeing most of the acute same-day appointments at the clinic, and 95% of them are far more complicated than initially advertised.
Runny nose & sore throat turns into a 32-yr-old G4P3 at 25 +3/7 wks with a history of 3 c-sections, recent gastric bypass surgery resulting in vitamin B12 deficiency, preeclampsia in 2 previous pregnancies...and a positive culture for strep throat!  And did I mention allergic to penicillin?
Urinary frequency becomes a 34-yr-old female with uterine fibroids, polycystic ovarian syndrome with associated insulin resistance, hypothyroidism, and a recent history of endometrial ablation for menorrhagia who stopped taking all of her meds (except xanax!) and has been feeling the urge to urinate Q15 mins for the past 5 months
Abdominal pain is actually a 19-yr-old diagnosed with ulcerative colitis at age 14 who is starting to have frequent stools with blood & mucous after a year of remission without meds...and the nearest gastroenterologist is 360 miles away in Anchorage!
Foot pain is revealed to be a 24-yr-old woman with chronic arthralgia, a recent ANA titer of 1:40 in a speckled pattern and a family history of lupus, awaiting a referral to the nearest rheumatologist 2245 miles away in...Seattle! [maybe she'll let me accompany her to her first rheum appointment and I can check on my apartment and say hello to my peeps at Swedish?]