The Rational Clinical Examination
David L. Simel, Drummond Rennie
David L. Simel, Marisa D'Silva
"A 21-year-old college student with a flulike illness for 2 days
presents to the student health clinic. You suspect influenza and
examine her oropharynx, neck, chest, and abdomen. When you feel
her liver edge about 2 cm below the costal margin, you inquire about
abdominal discomfort, nausea, vomiting, and anorexia other than
with the current illness. Her skin is not jaundiced. She has no
history of liver disease or illnesses associated with liver enlargement.
You reexamine the abdomen to confirm the presence of the liver edge
and additionally find no evidence for splenomegaly...."
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