Vital Signs: Temperature 99°F, Blood Pressure 150/90 mmHg, Heart Rate 90 beats/min, Respiratory Rate 20 breaths/min
General Appearance: Appears uncomfortable, speaking in short sentences on nasal cannula
HEENT: Pupils equal round and reactive to light, bilateral episcleritis, sinuses non-tender to palpation, dry mucus membranes, two shallow ulcers on sides of tongue
Lymph: No lymphadenopathy
Cardiovascular: No JVD, regular rhythm, no rubs/murmurs/gallops
Pulmonary: Labored breathing, clear bilaterally without wheezes, rhonchi, or rhales
Abdominal: Soft, nontender, nondistended, normoactive bowel sounds, no hepatosplenomegaly
Extremities: 2+ bilateral pitting edema to shins bilaterally, no clubbing, right great toe with tenderness and dusky discoloration
Neurologic: awake, alert, answers appropriately
Skin: Scattered palpable purpura and petechiae on bilateral lower extremities and abdomen, non-blanching, no tenderness to palpation of lesions, with several faded lesions on upper extremities
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Case 18 Index
Case 18 Introduction