Name: Monica Schulman Sex: F DOB:3/27/62 Ht: 5 7 Wt: 165 lbs Chief Complaint: Pain in the left hand History of Present Illness: Onset- gradual over the last 3 weeks. Mechanism of injury- none that she can remember Precise location- left hand What makes it worse- looking over her left shoulder and the neck forward, especially when cleaning over her head . What makes it better- lying down Quality of injury-burning sensation Radiation-into left arm, forearm , and left thumb Severity-started at 2/10; now 5/10 Timing- Worse towards the evening Associated symptoms: Fatigue Past Medical History No previous illnesses, trauma, or surgeries. Her last Physical exam was 6 mos ago for her biannual checkup for HT. Drugs: hydrochlorothiazide and atenolol for HT for 5 years. Family and Social History Married for 20 yrs and has a son and daughter, 18 and 15 respectively. Mother and father are healthy and so is her one brother. Occupation- housewife Diet- fresh vegetables, fish daily and fruits Does not smoke or drink Hobbies- knitting and quilting Stressful changes- eldest daughter going off to college Review of Systems Constitutional- fatigue, esp in the afternoon HEENT, respiratory , cardiovascular , GI, genitourinary , immune, lymphatic endocrine ,and integumentary are all NORMAL Gynecological- LMP 1 week ago; 10/28 day cycle, G2P2 heavy bleeding for the first 5 days Musculoskeletal- weakness in her left grip Review of Systems Constitutional- fatigue, esp in the afternoon HEENT, respiratory, cardiovascular, GI, genitourinary , immune, lymphatic endocrine,and integumentary are all NORMAL Gynecological- LMP 1 week ago; 10/28 day cycle, G2P2 heavy bleeding for the first 5 days Musculoskeletal- weakness in her left grip Physical Exams/Labs Vitals: T- 98.2 P- 88/bpm and regular, R 14/m, BP- 148/98 CBC- RBC, Hb, MCV, MCHC are all below normal Urinalysis indicates sugar in the urine Cholesterol and Triglycerides are high