text:  In general   confused white man   in mild distress . Vital signs  Temperature was 102   heart rate was 110   respiratory rate was 22   blood pressure was 113  63 . His head   eyes   ears   nose   throat was benign . His neck was supple . Lungs  Rales at the right base   bilateral decreased breath sounds at the bases . Cor  Regular rate and rhythm   S1 and S2   no extra heart sounds   abdomen distended with an epigastric mass noted   mildly tender to palpation   no guarding . Bowel sounds were present . The neurological examination was nonfocal .