The patient is of a slightly muscular build and tends to avoid eye contact. The hed and neck exam is unremarkable.
Lungs are clear to auscultation and the heart has a regular rate and rhythm with no murmurs.
The neurological exam reveals an exaggerated left knee jerk reflex. No other abnormalities are noted. A PPD skin test is positive at 20mm. The CXR is normal. Assignment Develop a comprehensive list of problems to be addressed in the patient management and counseling plan.