For the following cases, what are the signs AND symptoms
mentioned, whether the patient has them or not? (30)
The patient was a 4-month-old female with congenital heart
disease who was admitted to the hospital in January with severe
respiratory distress. Five days prior to admission she had
developed a cough and rhinitis. Two days later she began wheezing
and was noted to have a fever. She was brought to the emergency
room when she became lethargic. On examination she was agitated and
coughing. She had a fever of 38.90C, tachycardia with a
pulse of 220, tachypnea with respirations of 80/min., and a blood
pressure of 90/58 mm Hg.
A 35-year-old woman is seen for easy fatigue for many months.
She is now 24 weeks pregnant with her 3rd child in 3 years. She
does not see any obstetrician and does not take any vitamins.
Lately, she has developed a taste for eating ice. She has no other
complaint. Family and past history are negative. She does not smoke
or drink. Physical examination is positive for pale conjunctiva,
mild spooning of nails, and an II/VI systolic murmur at left lower
sternal border. Stools are negative for occult blood
A 26-year-old female presents to you in the STD clinic with a
complaint of fever of three days duration, nausea, and lower
abdominal pain. She denies a history of dysuria, hematuria, or
genital ulcerations. She denies that she may be pregnant. She has
an intrauterine device for 2 years. She takes no prescribed
medications and she has no allergies. On examination, she has a
temperature of 390C, pulse rate of 110 per minute, respiration rate
of 28 per minute, and B/P of 100/60. She is ill appearing and
diaphoretic. There is no lymphadenapathy. She has right lower
quadrant tenderness to deep palpation. Bowel sounds are present but
hypoactive. Her pelvic examination reveals right adnexal tenderness
and cervical motion tenderness. The uterus is tender and slightly
enlarged. Thick yellow vaginal discharge is sent for
microbiological studies.