Case 15: Physical Exam

Case 15 Index

Vital Signs: Temperature 100°F, Blood Pressure 100/80 mmHg, Heart Rate 90 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, healing right lower quadrant abdominal scar
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!
Cytomegalovirus (CMV) infection
Adenovirus infection
Acute cellular rejection (ACR)
Antibody-mediated rejection (AMR)
Mycophenolate-mofetil induced diarrhea
Tacrolimus-induced diarrhea
Pneumocystis jiroveci pneumonia (PJP)
BK virus infection
Post-transplant lymphoproliferative disorder (PTLD)

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Case 15 Index
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