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JANE DOE
DOB:
Patient presents today for follow up evaluation of
tachycardia.
The patient did try the Wellbutrin and developed a fast heart
rate. She did
discontinue the Zyban, thought she was better and restarted exercising. She still feels
her pulse is too fast. The patient denies any diarrhea, weight
loss, difficulty sleeping or tremors. She notes no chest pain, shortness of
breath, orthopnea or PND. The patient also presents today for recheck
of her borderline elevated blood pressure that was noted at her last
visit.
PHYSICAL EXAMINATION:
Weight is 170 pounds. Blood pressure 144/94 on the right arm and
134/90 on the left.
Pulse 92.
Lungs clear to auscultation and percussion. Examination of the
heart reveals a regular rate and rhythm without click, gallop, murmur, or
rub. No
thyromegaly is noted. EKG reveals sinus rhythm. Occasional
PACs. She has
no abdominal bruits noted. Funduscopic exam is benign. Carotids without
bruits.
ASSESSMENT:
1.Elevated blood pressure.
2.Tachycardia.
3.Nicotine dependency.
PLAN:
The patient is to continue to work on discontinuing
smoking. She
continues to try to make some adjustments in her smoking habits. She will continue
with diet and exercise. Will recheck her blood pressure here in
eight weeks.
She has been taking some Sudafed for her upper respiratory infection,
and this may, in fact, be elevating her blood pressure somewhat. She will follow up
here in about eight weeks.
PENDING
LABS:
TSH, which she will be advised of these results by phone.
LABS/DIAGNOSTIC ORDERS: None.
NEXT
APPOINTMENT: Follow up in eight
weeks.
___/ht:___
_________________, M.D.
JANE DOE
DOB:
Jane presents today for follow up after recent physical
examination.
She did have a stress echo in the interim, and this was negative for
any ischemia.
The patient's labs were reviewed with her, and she was advised that she
has developed type 2 diabetes mellitus. She has had three serial glucoses over
126. She has
an elevated glycohemoglobin of 7.7%, which is in the good to fair control
range. Her
cholesterol is elevated with LDL of 141. Other labs are within normal limits with the
exception of glucose present in the urine. The patient has family history of type 2
diabetes mellitus.
Her mother was Insulin requiring at the time of her death. The patient states
that in the interim she has joined Weight Watchers. She is still
waiting to meet with the personnel from Employee Assistance. She states she is
doing a bit better with regard to some of the depressive symptoms that she was
having. She
states she is sleeping a bit better than she had been. She also states
she is having fewer of the crying episodes, but she is unsure if it is just
simply that she is distracted by other things at this point and that may, in
fact, be what has resulted in her improved symptoms.
PHYSICAL EXAMINATION:
Weight is 229 pounds. Pulse 84. She is mildly tearful. Exam is otherwise
not performed.
ASSESSMENT:
1.Type 2 diabetes mellitus.
2.Depression.
PLAN:
Continue with Celexa 20 mg daily. Will start the
patient on Glucophage XR 500 mg q.d. She will be referred to diabetic nurse
educator. She
did manage to care for her mother's diabetes in the past and so is able to use
a glucometer proficiently. She will review dietary requirements but
should be doing quite well already in this regard as she has joined Weight
Watchers. She
was encouraged to continue with her dietary management. She will follow up
here in one month.
PENDING
LABS:
None.
LABS/DIAGNOSTIC ORDERS: Glucose in one
month.
NEXT
APPOINTMENT: Follow up in one
month.
___ht:___
________________, M.D.
JANE DOE
DOB:
Jane presents today for follow up of her hypertrophic
cardiomyopathy.
The patient did run out of the Lasix on Monday. Her sister states
that she also felt she had done better with regard to her breathing. She dislikes the
diuretic effect of the furosemide.
PHYSICAL EXAMINATION:
Weight is 110 pounds, which is down 1 pound from her last
visit. Pulse
72. Blood
pressure 130/80.
Lungs clear to auscultation and percussion. Examination of the
heart reveals a regular rate and rhythm with a grade 2/6 systolic murmur.
ASSESSMENT:
1.Hypertrophic cardiomyopathy.
2.Hypertension.
PLAN:
Check sodium, potassium and creatinine. Follow up here in
one month.
PENDING
LABS:
Sodium, potassium, creatinine.
LABS/DIAGNOSTIC ORDERS: None.
NEXT
APPOINTMENT: Follow up in one
month.
ABC/ht:slh
______________________, M.D.
JANE DOE
DOB:
Jane presents today for follow up of bilateral arm
symptoms.
These are intermittent in nature. She describes this sensation as being
somewhat numb.
She states she has some times where she has episodes, for which she was
evaluated, where she just is unable to raise her arm above her head to brush
her hair. She
states the arms feel diffusely weak. She states her mother and her uncle both
have numb hands.
She denies any headache. She denies any vision disturbance. She notes she has
some difficulty with her memory. She also has a number of days where she will
feel well and other days where she feels completely wiped out. She states there
are times when her thinking is clear and other times when it is not. She states her son
has attention deficit disorder, and she feels that she likely has had this
problem. In
fact, in the past she had been advised to start Ritalin but never did.
PHYSICAL EXAMINATION:
Weight is 149 pounds. Pulse 92. Blood pressure 120/60. She is somewhat
pale in appearance.
Lungs clear to auscultation and percussion. Examination of the
heart reveals a regular rate and rhythm without click, gallop, murmur, or
rub. She has
no tenderness on palpation of trigger points. DTRs are 2/2 and symmetric. Motor strength is
5/5 throughout.
Gait and station are normal.
ASSESSMENT:
1.Bilateral arm numbness.
2.Memory disturbance.
3.Iron-deficiency anemia.
4.Sjogren's syndrome.
PLAN:
In light of the patient's significant fatigue, we will
recheck her iron studies. In light of her numbness and family history
of numb hands, we will check B-12 levels. Also will check TSH, sedimentation rate and
C-reactive protein.
Suggested nerve conduction studies, but the patient states she does not
like pain and really does not wish to proceed with this at this time. Also discussed
with the patient having evaluation for attention deficit disorder and seeking
assistance of one of the psychiatrists. She states she will think this over for the
next few weeks.
She will follow up with me in one month. She is having some additional problems with
her periods at this time, and this may be contributing somewhat to her
fatigue. She
did take her birth control pill continuously while she was gone on vacation
and may be having a heavier period at this time related to that fact. Will see how she
responds over the next month.
PENDING
LABS:
Ferritin, TSH, B-12, hemogram, sedimentation rate, C-reactive
protein.
LABS/DIAGNOSTIC ORDERS: None.
NEXT
APPOINTMENT: Follow up in one
month.
___/ht:___
_____________________, M.D.
JANE DOE
DOB:
Jane presents today for follow up of hypertension. She has been
feeling well.
She denies any problems with chest pain or shortness of breath.
PHYSICAL EXAMINATION:
Weight is 95 pounds, which is down 4 pounds from her last
visit. Pulse
84. Blood
pressure 180/84.
ASSESSMENT:
Hypertension.
PLAN:
Add hydrochlorothiazide 25 mg daily. Check sodium,
potassium, creatinine. Recheck blood pressure in two weeks.
PENDING
LABS:
None.
LABS/DIAGNOSTIC ORDERS: Sodium, potassium
and creatinine.
NEXT
APPOINTMENT: Follow up in two
weeks.
DLQ/ht:kjm John
Doe
, M.D.
JANE
DOE
DOB:
Jane presents today for follow up. The patient did
winter in
PHYSICAL EXAMINATION:
Weight is 198 pounds. Pulse 72. Blood pressure 160/90, and this is
consistent with blood pressure readings she had when she was in
ASSESSMENT:
1.Hypertension.
2.Hyperlipidemia.
3.Right shoulder actinic keratosis vs. early squamous cell
carcinoma.
4.Coronary artery disease.
PLAN:
The patient will increase Toprol XL to 100 mg q.d. Will recheck
blood pressure in three weeks. She will be referred to dermatology for
excision of the lesion on her right shoulder. Will continue to monitor regarding her
episodes of stable exertional angina.
PENDING LABS: None.
LABS/DIAGNOSTIC ORDERS: Dermatology
evaluation.
NEXT
APPOINTMENT: Follow up in
three weeks.
DOC/ht:slh
_____________________, M.D.
JANE DOE
DOB:
JANE presents today with complaint of cough productive of
greenish-yellow sputum which has been present for approximately four
days. The
patient admits to related left ear pain as well as rhinorrhea. The patient states
she has had intermittent fevers, and her highest temperature has been
102.0°. The patient admits
to pleuritic type chest pain as well as myalgias. The patient states
she has had ongoing wheezing as well as shortness of breath. The patient denies
tobacco use.
The patient states she called in earlier this week with her symptoms
and was placed on a Z-PAK as well as given cough medicine.
PHYSICAL EXAMINATION:
The patient is a young Caucasian female who is alert and
oriented. She
has audible wheezes during conversation. The patient coughs frequently. Skin is warm, dry
and intact.
Pupils are equally round and responsive to light and accomodation. No scleral icterus
noted. No
conjunctival injection appreciated. TMs are intact bilaterally with good cone of
light. No
erythema or exudate.
Nasal septum is midline with both airways freely patent. Frontal and
maxillary sinuses are nontender to palpation. Oropharynx without erythema or exudate. Oral mucous
membranes are moist.
Neck is supple without lymphadenopathy. Cardiovascular exam reveals heart is regular
rate and rhythm without murmur. Lungs with scattered wheezes throughout all
lung fields.
The patient has diminished air movement. Extremities without clubbing, cyanosis, or
edema.
ASSESSMENT:
Acute bronchitis with asthma exacerbation.
PLAN:
The patient is to continue Z-PAK for the full course. The patient was
given Proventil metered-dose inhaler to use 2 puffs q.4h. p.r.n. for
wheezing. The
patient was given Tessalon Perles for cough and instructed to obtain saline
nasal spray to help with drainage. The patient is to call or come in if
symptoms worsen.
The patient is to return to the clinic p.r.n.
DOC/ht:___
______________________, M.D.
JANE DOE
DOB:
Jane presents today with complaint of headache, sore
throat, muscle weakness and fatigue for approximately seven to ten days. Connie denies any
fevers, chills or night sweats. The patient denies nausea, vomiting or
rashes. The
patient denies cough, shortness of breath or chest pain. Connie states she
had an episode of pressure in her chest yesterday which was brief and resolved
on its own.
The patient does admit to rhinorrhea as well as tooth pain. The patient states
she does have some pressure in her sinuses and some left ear pressure at this
time but denies any facial pain.
PHYSICAL EXAMINATION:
Temperature 98.0°. General: The patient is a
middle-aged female who is alert and oriented in no apparent distress at the
time of examination.
Breathing is nonlabored. HEENT: Head is normocephalic, atraumatic. Pupils are equal,
round, reactive to light and accommodation. Extraocular muscles are intact
bilaterally.
No scleral icterus noted. No conjunctival injection noted. Skin is warm, dry
and intact.
Nasal septum is midline with both airways freely patent. Tympanic membranes
are intact bilaterally with good cone of light. Oropharynx without erythema or exudate. Oral mucous
membranes are moist.
Neck is supple without lymphadenopathy. No carotid bruits auscultated. Frontal and
maxillary sinuses are nontender to palpation. Lungs are clear to auscultation in all lung
fields.
ASSESSMENT:
Upper respiratory infection, viral.
PLAN:
The patient is to continue Claritin 10 mg p.o. p.r.n. as
well as Tylenol p.r.n. for symptomatic treatment. As there is no
evidence of bacterial infection at this time, do not recommend antibiotic
treatment.
The patient is instructed to call the clinic if symptoms worsen and is
to follow up p.r.n.
DOC/ht:___
Doctor, Doe, M.D.
JOHN DOE
DOB:
John presents today for two-week follow up. The patient states
he has felt awful and has seen no improvement over the past two weeks. The patient
continues to have numerous complaints. He continues to feel weak and have poor
balance. The patient reports he has fallen one to two times at home and
consistently feels off balance. Patient with complaint of pain in his chest,
abdomen, back, hips, hands and knees. The patient states he continues to have
heaviness in his left chest which he describes as a pressure. He states it is
not like the angina he has had in the past. The patient states he has ongoing trouble
with shortness of breath and continues to complain of problems with
dyspnea. The
patient denies any change in cough but occasionally will have sputum
production.
The patient admits to a burning sensation in the epigastrium and
complains of abdominal pain. The patient denies any fevers, chills,
nausea or vomiting.
The patient denies any stool changes. The patient does state that he has had pain
in his testicles intermittently for approximately six months. The patient denies
any pain with urination, hematuria, urgency or frequency. The patient states
he has had no difficulty passing his urine. The patient denies any discharge from his
penis. The
patient denies any change in sexual partners.
PHYSICAL EXAMINATION: Weight is 181
pounds. Pulse
72. Blood
pressure 122/72.
Pulse ox 95%.
General:
The patient is a middle-aged male who is alert and oriented x 3. He appears to be
mildly distressed during examination. The patient's breathing is nonlabored with
conversation.
Head normocephalic, atraumatic. Pupils are equal, round, reactive to light
and accommodation.
Oropharynx without erythema or exudate. Oral mucous membranes are moist. Neck is supple
without lymphadenopathy. No carotid bruits auscultated. Lungs clear to
auscultation and percussion throughout all lung fields. Examination of the
heart reveals a regular rate and rhythm with a grade 1/6 systolic ejection
murmur.
Abdomen is soft with positive bowel sounds. No masses or
organomegaly appreciated. The patient has diffuse tenderness
throughout the abdomen with point tenderness on deep palpation of the left
lower quadrant.
No rebound or guarding is noted. No abdominal bruit or pulsatile mass
appreciated.
Examination of the testicles reveals no rashes, edema, or nodules with
palpation.
Testicles are appropriately descended. No evidence of discharge from the
penis. Exam
is negative for inguinal hernias. Rectal exam reveals a prostate which is
slightly tender with palpation. No evidence of blood on stool guaiac.
ASSESSMENT: 1.Abdominal pain.
2.Dyspnea.
3.Cogan syndrome.
4.Chest pain.
5.Prostatitis.
6.Fibromyalgia.
7.Coronary artery disease.
8.Bilateral avascular necrosis.
9.Hypothyroidism.
10.Disequilibrium.
PLAN: The patient is to
continue current medications, and refills were provided today. Will place the
patient on Levaquin 250 mg p.o. q.d. for one week to help with the
prostatitis.
Urinalysis and white blood cell count were obtained which were within
normal limits.
Will obtain full pulmonary function tests, both pre and post, with DLCO
to further evaluate dyspnea. The patient will be scheduled for an
echocardiogram given his atypical chest pain and history of coronary artery
disease. The patient is to return in two weeks for follow up and is to call if
problems occur prior to that follow-up appointment.
PENDING
LABS:
None.
LABS/DIAGNOSTIC ORDERS: Pulmonary function
tests, echocardiogram.
NEXT
APPOINTMENT: Follow up in two
weeks.
DOC/ht:___
DOE, JANE
PROCEDURE NOTE FOR
FLEXIBLE SIGMOIDOSCOPY
INDICATION:
Screening in this woman of average risk.
PROCEDURE:
After overnight prep with Colyte and informed consent, vital signs were taken. BP 134/78. Pulse 78. Digital rectal exam was performed in the left lateral decubitus position. The Welch Allyn video-scope was then passed to 45 cm, at which point some spasm precluded further passage. Upon withdrawal of the scope, careful inspection of the mucosa revealed no mucosal abnormalities, no diverticula, no polyps. Normal haustral markings and vascular pattern. No hemorrhoids. The patient tolerated the procedure well.
ASSESSMENT:
1.Normal flexible sigmoidoscopy to 45 cm.
PLAN:
1.Follow-up study in 5 years with yearly hemoccults in between.
___:ht:___ ____________________, M.D.
DOE, JOHN
CHIEF COMPLAINT:
Follow-up oligoarthritis.
HISTORY OF PRESENT ILLNESS:
He continues to have pain in his right wrist. His left knee has been intermittently quite swollen, warm and painful. He has now also noted pain, swelling and decreased interdental opening in the left jaw. He denies dry mouth or dry eyes. He has not had fever. He has checked his temperature several times, at home, and it is always under 98.0 degrees. He is not taking ibuprofen currently. He has become rather discouraged about the course of events.
MEDICATIONS:
1.Prednisone 15 mg q.d.
2.Propacet occasionally.
ALLERGIES:
N/A.
PHYSICAL EXAMINATION:
Weight 171 lb. BP 128/84. Pulse 88. He is alert and in no acute distress. His left jaw area appears to be mildly swollen. The parotid is not focally tender. There is no mass. His oral mucosa is normal. Dentition is good. There are no sensitive teeth. Temporomandibular joint range of motion is probably at or near normal, maybe slightly reduced on the left. He has no cervical adenopathy. No skin rash. His right wrist is warm, swollen, tender with pain on range of motion, pain on grip of his hand. His left knee has a large effusion. It is 2+ warm. Left, 3rd DIP joint is not red or swollen at this juncture.
X-ray films of wrist appear normal. X-ray films of left knee appear normal. His joint fluid analysis showed good muse and clot. A white count of about 3000, cultures that are negative, crystal exam negative, rheumatoid factor negative.
ASSESSMENT:
1. Polyarthritis. Possibly secondary to parvovirus B19 infection, reactive. Rule out atypical seronegative rheumatoid arthritis.
PLAN:
1.Increase ibuprofen to 800 mg t.i.d. with meals. Continue prednisone 15 mg q.d. Continue p.r.n. Propacet and
icing of the joints. Will arrange for consultation with rheumatology. He is to follow-up in 2 weeks after he has seen
the rheumatologist. Consider Plaquenil, methotrexate, intra-articular steroids.
___/ht:___ ___________________, M.D.
DOE, JANE
CHIEF COMPLAINT:
Follow-up:
1.Hypertension.
HISTORY OF PRESENT ILLNESS:
She reports that her blood pressure values at home have been good. She is not having any chest pain or dyspnea. She has a little bit of yellow vaginal discharge while taking Premarin, but denies spotting, bleeding, itching or redness. She is due to have cataract surgery at some point in the near future, per Dr. Husain. Her back and hip pain is doing well. She has had no acute flare-ups. She has chronic, degenerative changes in her hands. She has some forearm discomfort, left greater than right, that extends from her wrist proximally. She has marked deformities of degenerative arthritis in each hand.
MEDICATIONS:
N/A.
ALLERGIES:
N/A.
PHYSICAL EXAMINATION:
Weight 150 lb. BP 136/80 left and 132/80 right arm, sitting. Pulse initially 110. Respirations unlabored. Chest is clear to auscultation and percussion. Heart RRR. Fingers show marked degenerative changes. Extremities show no edema. Abdomen is soft, obese and nontender.
ASSESSMENT:
1.Hypertension, well controlled.
2.Degenerative osteoarthritis.
3.Possible left carpal tunnel syndrome.
PLAN:
1.I offered her splint therapy for her wrist and she declined. She will follow-up with me in 4-6 months. Continue
current medications.
___/ht:___ __________________, M.D.
DOE, JON
CHIEF COMPLAINT:
Annual physical examination.
IDENTIFICATION:
48-year-old gentleman who is married. An assistant
director of the
HISTORY OF PRESENT ILLNESS:
Previous problems have been spells, borderline hypertension, gastroesophageal reflux disease, history of myoclonal gammopathy of unspecified significance.
Patient reports that he has been feeling relatively well. He has had no spells of flushing, dizziness or weakness in the last 12-18 months. He is exercising vigorously but is not following a restricted diet. He wants to eat all the time. In fact his appetite is excessively good. He lifts weights 3 times a week and does aerobic activity, including bicycle riding, regularly.
His right knee is persistently swollen and painful. He has decreased range of motion. He has seen
Dr. D. Goetz in the past. Feels better when he uses the bicycle than when running or walking. He takes occasional ibuprofen and ices it.
He has had a recent upper respiratory infection with congestion and cough. No fever. Seems to be improving gradually. Denies any exertional chest pain, palpitations. Blood pressure readings, when checked sporadically, out of the office, 145-150/90-94. He notes that if he over-eats he gets some increased indigestion, a full feeling that is uncomfortable. It lasts for several hours. It is not exertional or associated with vomiting. He denies any other gastrointestinal symptoms.
PAST MEDICAL HISTORY:
Otherwise unchanged. See notes from previous exams at Mayo Clinic evaluation.
SOCIAL HISTORY:
Tobacco: Nonsmoker.
Alcohol: Minimal.
Exercise: Regularly.
MEDICATIONS:
1.Ranitidine 150 mg b.i.d.
2.Valtrex p.r.n. outbreaks of herpes simplex virus cold sores.
3.Occasional generic Robitussin.
4.Not taking vitamins.
ALLERGIES:
Unchanged.
FAMILY HISTORY:
Unchanged.
REVIEW OF SYSTEMS:
GENERAL: Patient denies any fevers, chills, night sweats, headaches, or weight gain or loss.
SKIN: Patient has a small area at the left lateral eye canthus that he would like to have checked. He denies change
in any moles, skin rash, or any problems with his fingernails or toenails.
HEENT: Patient has had facial herpes simplex outbreaks periodically. Usually once or twice a year. Valtrex is
helpful. He denies any frequent sore throats, sinus infections, blurred vision, double vision, vertigo, epistaxis, or
lymph node enlargement.
CARDIAC: Patient denies any chest pain, shortness of breath, palpitations, dizziness, or syncope.
PULMONARY: Patient denies any chronic cough, chest congestion, or wheezing.
ENDOCRINE: Patient denies any diabetic symptoms.
GI: See HPI.
Page 2
DOE, JON
GU: Patient denies any burning, urgency, frequency, hematuria, pyuria, flank pain, or nocturia. Might have some
nocturia x 1, variable with food and fluid intake.
EXTREMITIES: His shoulder is improved. Only if he presses heavy weights will he develop some shoulder
discomfort. See HPI.
NEUROLOGIC: Patient feels fidgety in his knees, sometimes at night. Worse if he is physically inactive. He denies
any numbness, tingling, or weakness of any extremity. Denies slurred speech, hearing or visual difficulties, or
ambulation difficulties.
HEMATOLOGIC: Patient denies anemia, bleeding disorders, or clotting problems.
PHYSICAL EXAMINATION: Well-developed, well-nourished, pleasant gentleman in no acute distress.
VITAL SIGNS: Height 6'3". Weight 256 lb. Pulse 80. BP 154/96 right and left and 154/98.
SKIN: Notable only for some mild, malar telangiectasia and a small, inspissated, milia type lesion in the left, lateral
canthus of his eye. It is approximately 2-3 mm in diameter.No suspicious lesions or rashes.
HEENT: PERRL. EOMI. Pharynx is clear. Tympanic membranes are normal. Oral mucosa is normal.
Funduscopic exam reveals no hemorrhages or exudates. No papilledema.
NECK : No adenopathy, masses, JVD, or bruits.
THYROID: Is palpable but without bruit or nodule.
CHEST: Lungs are clear to auscultation and percussion. Breasts are normal.
THORAX: Spine and CVA nontender.
CARDIAC: Regular rate and rhythm. Normal S1, S2 without S3, S4, murmur, or rub.
ABDOMEN:Soft with a healed, right lower quadrant scar. Bowel sounds are normal. No hepatosplenomegaly.
No tenderness, masses, guarding, rebound or bruit. Femoral pulses intact.
GU:Testes descended bilaterally. Penis is circumcised. No masses or hernias.
RECTAL:Guaiac negative. Prostate is smooth and soft without nodules. Not enlarged. No apparent external
lesions. No hemorrhoid palpable. Sphincter tone normal.
EXTREMITIES: Right knee has a 10 degree flexion deformity. He has small effusion and crepitus on range of motion. There are hypertrophic changes and jointline tenderness. His right shoulder has good range of motion. He has some moderate, superficial, enlarged varicosities in the, left greater than right, lower extremity below the knee. No clubbing, cyanosis, edema, or synovitis.
PULSES:2+ and full. No carotid bruits.
NEUROLOGIC: Alert, oriented, and fluent. Deep tendon reflexes are normal. Plantar responses are downgoing.
Muscle strength is symmetric.
NODES: No lymphadenopathy is noted in the neck, axillae, or groin.
ASSESSMENT/PLAN:
1. Hypertension. We have observed this now for quite some time, off medication. He has not been able to
normalize it or reduce his weight. Begin HCTZ/triamterene 25 mg/37.5 mg q.d. Side effects discussed. Repeat
blood pressure readings here in 3 months.
2. History of spells, possibly related to male menopause versus mastocytosis versus unknown etiology, resolved.
3. Gastroesophageal reflux disease. Continue ranitidine.
4. Degenerative joint disease, right knee. He is going to continue to live with this for the time being as he feels he
is not yet ready for joint replacement surgery. Option exists to see Dr. Goetz at any time.
5. Mild upper respiratory infection.
6. History of myoclonal gammopathy per the Mayo Clinic's notes. Serum protein electrophoresis.
7. Health care maintenance. Stools for occult blood, PSA, urinalysis and lipid profile. Return in 3 months. Results
to be communicated by lab letter.
PENDING LABS: Stools for occult blood, PSA, urinalysis, lipid profile.
LABS/DIAGNOSTIC STUDIES: Serum protein electrophoresis.
___/ht:___ _______________, M.D.
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