Case 13: Physical Exam

Case 13 Index

Vital Signs: Temperature 98°F, Blood Pressure 130/80 mmHg, Heart Rate 75 beats/min, Respiratory Rate 14 breaths/min
General Appearance: In no acute distress
HEENT: Normal conjunctiva, no scleral icterus, dry 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: soft, non-tender, non-distended
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!
Cisplatin-induced salt wasting
Syndrome of inappropriate antidiuretic hormone (SIADH) due to SSRI use
Syndrome of inappropriate antidiuretic hormone (SIADH) due to post-operative stress
Low solute intake (tea & toast diet, beer potomania)
Glucocorticoid deficiency
Cyclophosphamide-induced SIADH
Congestive heart failure

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