SOLVED887

HPI: IW is a 45 y.o. WM who presents to the urgent care center complaining of three days of fever and chills. He thinks he has the flu and complains of painful bumps on his fingers and toes for the last couple days. He states he has a couple of back teeth that have been causing pain and he needs to have pulled, but he doesn’t have the money to see a dentist. PMH: Smoker x 25 years. Unknown substance use listed. NKDA. FH/SH: Lives with wife. Works for Samsung on the assembly line. Rare ETOH (alcohol), mostly 2 beers on holidays. Parents alive and well. No sick contacts. No health insurance. Meds: HCTZ 25 mg daily, lisinopril 20 mg daily. ROS: Pain in fingers and toes at site of lesions, fatigue, and moderately reduced appetite. Other systems negative except as mentioned in HPI. Exam unremarkable except as follows: Skin is warm and moist, multiple tattoos on arms and chest, tachycardic with systolic murmur III/VI (grade). Multiple small nodules and macules ranging from red to dark purple and concentrated at distal ends of the fingers and toes. Tenderness to palpation of lesions. Poor dentition with visible dental caries observed to
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HEALTH SCIENCE
NURSING

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