The Importance of History and Exam in Differential Diagnosis

Luke O site, 8, presents to cash like children's emergency department with his mom due to a two week history of fatigue, soreness in his legs and fever. His parents originally thought that these issues were growing pains and gave him ibuprofen, which moderately relieved his symptoms. On exam, he has a couple bruises on his shins and knees and very stages of healing his cardiac and pulmonary exams are normal. But his abdominal exam reveals some hepatosflinomegalae, you think, as a resident, who knows, and no, without an opathy that you can feel. And then obviously if you happen to see any petechii either that's usually a good