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Surreptitious Coumadin Ingestion

Past Medical History

The past history is significant for juvenile onset diabetes mellitus and the hemolytic uremic syndrome at age 8 months. She had a tubal ligation in April, 1995, because of the diabetes. There were no bleeding problems during the tubal ligation.

Physical Examination

Well developed, well nourished female in no acute distress. Vital signs were stable.
HEENT: Benign.
Skin: Multiple ecchymotic areas were noted.
Neck: Supple.
Glands: Without adenopathy.
Lungs: Clear.
Breasts: Without masses.
Heart: Regular rate and rhythm without murmur or gallop.
Abdomen: Normal bowel sounds. Soft and nontender without masses or organomegaly.
GUR: External genitalia is normal. Nulliparous cervix without inflammation. The uterus is normal in size and is anterior in location. The adnexae were negative for masses.
Neurologic: Intact.