The Rational Clinical Examination
David L. Simel, Drummond Rennie
Michael J. Steiner, Darren A. DeWalt
dehydration, hypovolemia, pediatrics
"Worried parents bring a 3-year-old boy who is refusing to eat
or drink to your office. His illness started 4 days ago, with temperatures
as high as 39°C, increased sleepiness, and decreased oral intake.
On examination, his temperature is 38.7°C and he is alert but mildly
tachycardic and tachypneic. He has normal skin turgor, although
his mucous membranes are dry and his capillary refill is 3 seconds.
Also observed on examination are small vesicular and ulcerated lesions
on the posterior pharynx and red macules on the hands and feet...."
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