• The most notable finding on physical examination was icterus, detected in the mucous membranes of the sclera and oral cavity, on the pinna of the ears, and the abdominal skin. Although abdominal palpation was difficult due to her obesity, hepatomegaly was suspected. The muscle mass along the back was decreased and the spine could be readily palpated. All other findings were unremarkable.

Assessment of history and physical exam?