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PAST MEDICAL HISTORY: Asthma, status post hysterectomy, and status post umbilical hernia repair. The patient is status post multiple colonoscopies for diverticular disease.

FAMILY HISTORY: The patient’s brother died of colon cancer. No family history of gastric cancer, pancreatic cancer, hepatic cancer, inflammatory bowel disease, or peptic ulcer disease.

REVIEW OF SYSTEMS: No nausea, vomiting, melena, bright red blood per rectum, weight loss or loss of appetite.

PHYSICAL EXAMINATION:
Vital signs: Blood pressure is 120/70. Pulse is 68 per minute. Respiratory rate is 18.
General: This is a well-developed, well-nourished female in no acute distress.
HEENT: Normocephalic, atraumatic and anicteric. Conjunctiva is clear. Extraocular movements are intact.
Neck: No jugular venous distension. No carotid bruits.
Lungs: Clear to auscultation and percussion.
Heart: Regular rate and rhythm with 3/6 systolic murmur; no gallops or rubs (the patient was noted to have murmur and has been instructed regarding antibiotics prior to dental procedures).
Abdomen: Soft and nontender. Bowel sounds are present. No palpable masses. No hepatosplenomegaly.
Skin: Good turgor.
Extremities: Without clubbing or edema.
Nodes: No cervical or axillary adenopathy is appreciated.
Neurologic: The patient is alert and oriented to person, place and time; cranial nerves are grossly intact. No cogwheeling or resting tremor is noted.