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Gladys, a 24 year-old woman, complains of
dyspnea.
- Current illness
- Three weeks of worsening dyspnea.
- Intermittent 'hotness of body'.
- Anorexia.
- Non-productive cough
- Chest tightness
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- Past medical history:
- Treatment for malaria and tuberculosis.
- Completed eight month course of TB
treatment six months ago.
- Vital signs: T = 38.0°C, P = 120, BP =
110/60, R = 24
- Physical exam:
- Thin woman in mild distress sits on a
stool next to her bed.
- Pale conjunctiva and mucus membranes.
- Neck supple without adenopathy; elevated
JVP.
- Chest is clear with decreased breath
sounds in bases.
- Abdomen is unremarkable
- Trace lower extremity edema
She is admitted with a working diagnosis of of
recurrent tuberculosis, and started on anti-tubercular drugs. A chest
X-ray, EKG and ELIZA for HIV are ordered.Rounds,
the following morning. |
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