Marian is a 43-year-old Asian female who presents to your outpatient clinic with complaints of fever and productive cough. Denies tobacco and drug use Negative medical history Family history positive for cardiovascular

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Marian is a 43-year-old Asian female who presents to your outpatient clinic with complaints of fever and productive cough.

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Denies tobacco and drug use Negative medical history Family history positive for cardiovascular disease in her father

Reports a fever (max temp 101 F), fatigue, generalized muscle aches, and productive cough of green sputum x 5 days Starting today, Marian has developed shortness of breath with minimal activity. Review of systems:

VS: Temp 101.1 F, HR 94 bpm, RR 32 breaths/min, BP 92/48 mm Hg, SaO2 91% on room air General: Appears stated age; speech clear Skin: warm to touch; pallor present HEENT: Nasal congestion present Respiratory: crackles (rales) auscultated bilaterlly in lower lobes, positive use of accessory muscles at rest, tachypnea, dyspnea with exertion Cardiovascular: S1 and S2 auscultated, no murmurs present. Denies chest pain. Gastrointestinal: bowel sounds auscultated in all quadrants; abdomen soft and nontender Genitourinary: Denies dyruria Musculoskeletal: No edema of extremeties. Strength 5/5 in bilateral upper and lower extremities. Neurological: alert and oriented x 4; PERRLA

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