The clinical presentation of shock can be dramatic, as in profound hypotension caused by hemorrhage from a gunshot wound. Or shock can be subtle, as in heart failure or, even paradoxically, hypertensive crisis.1 I2 No single vital sign or value is diagnostic of shock; all vital signs are insensitive in detecting and assessing the severity of shock. Measurement of blood pressure can be particularly difficult due to peripheral vascular disease, tachycardia with a small pulse pressure, and irregular rhythms such as atrial fibrillation. Although not specific, physical findings taken as a composite are useful in the assessment of patients in shock ( Table 2,6,-3).
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.