Physical Findings

Stop & Think

Lab and X-Ray

Differential Diagnosis

The Disease

Treatment

Conclusions

Quiz & Evaluation

• Vital signs:
• Pulse = 88/min and regular
• BP = 140/84 mmHg
• Resp = 18
• Temp = 100.4
• HEENT is unremarkable. PERLA. No bruits over the carotids.
• Heart sounds are normal, no murmurs or gallops.
• Chest auscultation reveals diminished breath sounds and rales over the right lung. Uh oh, maybe we better order a gram stain and culture on his sputum.
• Prominence of neck and upper back fat pad.
• Rounded face .
• No abdominal masses. The liver is 4 finger breadths below the costal margin. Spleen is not palpable. Truncal obesity with abdominal stria.
• Peripheral pulse are equal bilaterally.
• Slight prostatic enlargement by digital exam. Stool negative for occult blood.