• Diarrhea and vomiting • Burns • Diuretic or laxative use HIV, human immunodeficiency virus After a detailed history and review of systems are performed, the patient should have a complete physical examination, focusing on vital signs, state of hydration, and potential findings suggestive of specific disease states These findings include anomalies of the face and oropharynx, signs of dehydration, hygiene, pallor, jaundice, murmur and/or cyanosis, clubbing, lymphadenopathy, dermatitis, hyperpigmentation, abdominal masses and/or tenderness, and oral ulcers, among many others Dysmorphic features should be noted and a thorough neurologic examination should be performed Infants should be observed breastfeeding or bottle feeding, with attention to latch and suck, observing for any gagging, choking, vomiting, sweating, or respiratory distress