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PAST MEDICAL HISTORY: Cholecystectomy in 1973. The patient had diabetes mellitus 10 years ago, cholesterol for 4 years, bacterial infection and kidney stones in April 2005.

ALLERGIES: No known drug allergies.

MEDICATIONS: Lipitor 40 mg daily, Toprol XL 50 mg, Actos 15 mg, and metformin 1000 mg.

FAMILY HISTORY: Father was killed. Mother alive with diabetes and hypertensive disease. There is no brother. Two sisters, one with diabetes mellitus.

SOCIAL HISTORY: The patient denied history of smoking or drinking. The patient works as a caseworker with no exposure to chemicals or asbestos.

REVIEW OF SYSTEMS: General: The patient has occasional chills. Eyes: Negative. ENT: Has sinus problem. Heart: Occasional swelling at ankles. Endocrine: Feels occasional heat intolerance. Psychological: Negative. Blood & Lymphatics: Anemia with easy bruisibility. Urination: Frequency and nocturia. Muscle & Bone: Positive for joint pain. Skin: Moist and intact. Neurological: Occasional numbness and tingling. Lungs: Occasional wheezing and shortness of breath. GI: Vague epigastric pain. Allergy: Negative.

PHYSICAL EXAMINATION: Physical examination shows a well-developed, elderly female in no apparent distress. Weight is 107 pounds. Blood pressure is 140/70. Heart rate is 72, respirations 24. HEENT: EOMI, PERRLA, sclera is nonicteric. Neck is supple. Lungs are clear to auscultation and percussion. Cardiac exam shows normal sinus rhythm. Exam of the chest shows irregular mass and the tumor has shrunk to less than 1 cm in diameter. No axillary lymph node is palpable. Abdomen is soft with no organomegaly. Bowel sounds are active. Extremities show no cyanosis, clubbing or edema. Neurological is grossly intact. Skin shows no petechiae or ecchymosis.