Case 45: Physical Exam

Case 45 Index

Vital Signs: Temperature 98.0; Blood Pressure 110/70 mm Hg; Heart rate 108 beats per minute, Respiratory rate 12 breaths/min; Body mass index 18 kg/m2

General Appearance: In no acute distress, thin
HEENT: Normal conjunctiva, no scleral icterus, dry mucous membranes, clear oropharynx; normal dentition
Lymph: No cervical lymphadenopathy
Cardiovascular: No JVD, regular rhythm, no rubs/murmurs/gallopsstethoscope
Pulmonary: Breath sounds normal bilaterally, no rales/rhonchi/wheezes
Abdominal: Soft, non-tender, not distended, no scars or striae
Extremities: Warm and well perfused, no peripheral edema of extremities; normal appearing hands and feet
Neurologic: Awake, alert, answers questions appropriately
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!
Diuretic abuse
Laxative abuse
Cushing’s syndrome
Bartter syndrome
Gitelman syndrome
Primary hyperaldosteronism
Surreptitious vomiting
Liddle syndrome
Proton-pump inhibitor side effect

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Case 45 Index
Case 45 Introduction