1. For the following cases, what are the signs AND symptomsmentioned, whether the patient has them or not? (30)
   1. The patient was a 4-month-old female with congenital heartdisease who was admitted to the hospital in January with severerespiratory distress. Five days prior to admission she haddeveloped a cough and rhinitis. Two days later she began wheezingand was noted to have a fever. She was brought to the emergencyroom when she became lethargic. On examination she was agitated andcoughing. She had a fever of 38.9⁰C, tachycardia with apulse of 220, tachypnea with respirations of 80/min., and a bloodpressure of 90/58 mm Hg.
   2. A 35-year-old woman is seen for easy fatigue for many months.She is now 24 weeks pregnant with her 3rd child in 3 years. Shedoes not see any obstetrician and does not take any vitamins.Lately, she has developed a taste for eating ice. She has no othercomplaint. Family and past history are negative. She does not smokeor drink. Physical examination is positive for pale conjunctiva,mild spooning of nails, and an II/VI systolic murmur at left lowersternal border. Stools are negative for occult blood
   3. A 26-year-old female presents to you in the STD clinic with acomplaint of fever of three days duration, nausea, and lowerabdominal pain. She denies a history of dysuria, hematuria, orgenital ulcerations. She denies that she may be pregnant. She hasan intrauterine device for 2 years. She takes no prescribedmedications and she has no allergies. On examination, she has atemperature of 390C, pulse rate of 110 per minute, respiration rateof 28 per minute, and B/P of 100/60. She is ill appearing anddiaphoretic. There is no lymphadenapathy. She has right lowerquadrant tenderness to deep palpation. Bowel sounds are present buthypoactive. Her pelvic examination reveals right adnexal tendernessand cervical motion tenderness. The uterus is tender and slightlyenlarged. Thick yellow vaginal discharge is sent formicrobiological studies.