History of Present Illness
Review of Systems
Past Medical History
Physical Examination
Essential Differential Diagnosis
Relevant Testing
Test Results 1
Relevant Next Steps
Test Results 2
Diagnosis
Treatment Orders
Question 1
Question 2
Question 3
About the Case
Nipple discharge in a 31 yo female
Physical Examination
General appearance
: Comfortable-appearing female who generally looks well and appears her stated age.
Vital signs
:
BMI: 22 kg/m
2
Temperature: 36.6° C
Pulse: 80 beats/minute and regular
Respirations: 18/min
BP: 135/74 mm Hg
Skin
: Normal color, no rash, hirsutism, or acne.
HEENT
: Pupils equal and reactive to light and accommodation. Normal visual fields to confrontation. Visual acuity 20/20 in both eyes. Fundi normal bilaterally. No thyroid enlargement or nodules.
Pulmonary
: Equal air entry and chest is clear on auscultation. No crackles or wheezes.
Cardiovascular
: Regular rate and rhythm with normal heart sounds. No murmurs. Normal peripheral pulses and capillary refill.
GYN
: No breast masses or skin changes. No axillary lymphadenopathy. Mild diffuse breast tenderness on palpation. Milky nipple discharge elicited bilaterally with pressure around areolae.
Gastrointestinal
: Abdomen soft, nontender, and nondistended. No organomegaly, and bowel sounds are normal.
Genitourinary
: Unremarkable
Musculoskeletal
: Unremarkable
Neurologic
: Normal and symmetric motor strength and reflexes on extremities. Sensation grossly intact to light touch. Cranial nerves 2 through 12 intact. Gait and balance normal.
Mental status
: Alert, oriented to person, place, and time. Affect seems slightly depressed.
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