Hyperglycemia in a 56-Year-Old Woman

Physical Examination

  • General appearance: Well-appearing female in no apparent distress, height 1.65 m, weight 95.3 kg (BMI 34.9)

  • Vital signs:
  • Temperature: 37° C
  • Pulse: 82 min
  • BP: 159/88 mmHg
  • Respirations: 12/min

  • Skin: There is velvety smooth hyperpigmentation in neck folds and under arms; no other lesions or rash.

  • HEENT: Moist mucous membranes, no exudates, no cervical lymphadenopathy.

  • Pulmonary: Clear to auscultation bilaterally, no wheezes, rales, or rhonchi.

  • Cardiovascular: Regular rate and rhythm; no murmurs, gallops, or rubs. Jugular venous distention normal.

  • Gastrointestinal: Obese abdomen, soft, non-distended, normal bowel sounds, no rebound or guarding.

  • Genitourinary: No signs of yeast infection or other lesions. No tenderness to flank percussion.

  • Musculoskeletal: No peripheral edema, swelling or tenderness. Joints full range of motion and nontender.

  • Neurologic: Decreased sensation to light touch in feet bilaterally. Cranial nerves II to VIII grossly intact, normal gait, strength 5/5 throughout.

  • Mental status: Alert and oriented x3