Physical exam

The following describes this patient’s physical exam when you first see him:

General appearance: No acute distress

Vital signs: T 101 F, BP 111/74, HR 99, RR 20, SpO2 98% on room air

Head and neck: Oropharynx clear, dry mucous membranes

Chest: Normal to inspection, palpation, percussion, and auscultation

CVS: S1, S2, no extra heart sounds, no murmurs

Abdomen: Soft, non-tender; mild splenomegaly

CNS: Alert and oriented; no focal deficits in strength or sensations

Lymph: No palpable cervical or supraclavicular lymphadenopathy; approximately 1.5 cm palpable lymphadenopathy in right axilla

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