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REVIEW OF SYSTEMS: No nausea, vomiting, abdominal pain, fevers, chills, melena, bright red blood per rectum, constipation, diarrhea, unintentional weight loss or loss of appetite; the patient underwent a negative colonoscopy within the past year.

PHYSICAL EXAMINATION:
General: This is a well-developed, overweight male 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. No gallops, rubs or murmurs.
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 appreciated.
Neurologic: The patient is alert and oriented to person, place and time; cranial nerves are intact.