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REVIEW OF SYSTEMS: CONSTITUTIONAL: No fever or chills, no weight loss. Does describe general malaise and some dizziness with sitting up. ENT: No upper respiratory infection symptoms. RESPIRATORY: No difficulty breathing. CARDIOVASCULAR: No chest pain. GI: As above. GU: No vaginal bleeding or vaginal discharge. No dysuria. No lower abdominal pain. PSYCHIATRIC: Normal affect.

PHYSICAL EXAMINATION:
VITAL SIGNS: Temperature 35.6, pulse of 70, respirations 36, blood pressure 100/76. GENERAL: The patient is a young girl. She is lying a little restless, complaining of severe pain.
HEENT: Atraumatic, normocephalic. Eyes: Pupils are equal and reactive. Oropharynx: Mucous membranes are a little dry.
NECK: Supple. No lymphadenopathy.
CARDIOVASCULAR: Regular rhythm and rate. No murmurs, gallops or rubs.
LUNGS: Clear to auscultation.
ABDOMEN: Soft. She is tender to palpation in the mid-epigastrium. There is no rebound or guarding. Normal active bowel sounds.
EXTREMITIES: No clubbing, cyanosis or edema.
NEUROLOGIC: No focal deficits.
SKIN: No rash or other lesions.