Case 10: Physical Exam

Case 10 Index

Vital Signs: Temperature 99.2°F, Blood Pressure 115/75 mmHg, Heart Rate 85 beats/min, Respiratory Rate 14 breaths/min
General Appearance: In no acute distress
HEENT: Normal conjunctiva, no scleral icterus, moist mucous membranes, clear oropharynx
Lymph: No lymphadenopathy
Cardiovascular: No JVD, regular rhythm, no rubs/murmurs/gallopsstethoscope
Pulmonary: Breath sounds normal bilaterally, no rales/rhonchi/wheezes
Abdominal: Hypoactive bowel sounds, distended but soft, diffuse tenderness to palpation with voluntary guarding, PD catheter site clean without erythema, fluctuance, or induration
Extremities: warm and well perfused, no peripheral edema of extremities
Neurologic: Alert, oriented x3, no focal deficits
Psychiatric: Calm, pleasant
Skin: Warm, dry, no rash

What’s at the top of your differential diagnosis in this patient? Choose 3 before moving on!
Peritoneal catheter exit site infection
Biliary colic
Ischemic colitis
Pelvic inflammatory disease
Urinary tract infection
Acute coronary syndrome
Small bowel obstruction
Encapsulating peritoneal sclerosis

Click here to move on!

Case 10 Index
Case 10 Introduction