Virginia C. Broudy, MD

University of Washington School of Medicine, Seattle, WA

This case was reviewed and updated in August 2013 by Dr. Eric Kraut and members of the Teaching Cases Subcommittee.

Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.


Physical examination reveals a slender plethoric (red-faced) man who is well-appearing. Blood pressure is 140/88; pulse is 82 and regular; respiratory rate is 12. The lungs are clear to auscultation; the cardiac exam reveals a normal S1 and S2 without murmur. The abdominal exam reveals that the spleen tip is palpable 3 cm below the left costal margin. The spleen is firm and nontender. The liver is not palpable. The extremities show no clubbing, cyanosis, or edema.

What aspects of the physical exam affect your diagnosis? Select all that apply.
The observation that he is slender
Clear lungs and normal cardiac exam
Palpable spleen tip

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