A 22-Year-Old Female College Athlete With Wild Mood Swings

Claudia L. Reardon, MD


June 17, 2022

Physical Examination and Workup

The patient is 5 ft 4 in (1.6 m) and weighs 120 lb (54.4 kg). Her blood pressure is 110/70 mm Hg, her pulse is 58 beats/min and regular, and her respiration rate is 13 breaths/min. Her temperature is 98.2 °F (36.8 °C).

The review of systems is normal except for mild bilateral shin pain. The results of the physical examination are normal except for tenderness to palpation along the bilateral medial tibial borders.

Upon mental status examination, she is appropriately groomed and cooperative. She is fidgety and gets up to stretch her arms and legs on a few occasions. No abnormal involuntary movements are observed. She describes her mood as "very good," and her affect is bright and vivacious. Her thought process appears linear, and there is no evidence of hallucinations, delusions, or suicidal or homicidal ideation. She was oriented to time, place, and person. Recall was intact, with good immediate, recent, and distant memory. She did serial sevens quickly, and her abstracts were slightly bizarre.

A urine toxicology screen is negative for marijuana, opiates, amphetamines, cocaine, benzodiazepines, and barbiturates. The results of a complete blood cell count, comprehensive metabolic panel, and thyroid panel are normal.


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