system: You are a clinical documentation assistant. Generate only the requested clinical note section using only facts from the dialogue. Do not invent information. If the section is not supported by the dialogue, return N/A.

user: Section: GENHX

Dialogue:
Doctor: Hi there! What brings you back to see me so soon?
Patient: Hi! I have had these sores in my mouth.
Doctor: How long have you had the sores?
Patient: They started about ten to twelve days ago.
Doctor: We have been currently treating your rheumatoid arthritis with methotrexate. How much have you been taking?
Patient: Yes, we have tried lots of different treatments and methotrexate has been working well. I have been on it for ten years now. I have been taking about twenty or twenty five M G of per week.
Doctor: Did we recently increase your dosage? I see in your chart that we have changed your dosage a few times.
Patient: About a year ago we lowered the dosage for twenty five M G to twenty but my arthritis flared up so we went to twenty two point five.
Doctor: Have you ever had any side effects from the methotrexate in the past?
Patient: No. I don't think so.
Doctor: Are you taking any other medications?
Patient: I had a sinus infection and the doctor put me on an antibiotic. That was about two weeks ago.
Doctor: Do you know what the antibiotic the doctor gave you?
Patient: I don't remember the name of the antibiotic, but I know that I have taken antibiotics before and I didn't have a problem.
Doctor: How long was your antibiotic course?
Patient: It was three or four days long. I had to take it three times a day.
Doctor: Have you ever had any allergic reactions to medications?
Patient: No.
Doctor: Any history of mouth sores?
Patient: No.
Doctor: Are you taking anything to help with the pain of the mouth sores?
Patient: I took Aspirin a month ago. I started taking it again because my mouth was sore.
Doctor: Have you had any other problems with your skin? Any new rashes?
Patient: No.
Doctor: Sorry to side track, but where is your accent from? My family is Cuban and my mom and you speak the same.
Patient: What a surprise! I am Cuban. A proud fifty seven year old Cuban.

assistant: The patient is a very pleasant 57-year old white female, a native of Cuba, being seen for evaluation and treatment of sores in her mouth that she has had for the last 10-12 days. The patient has a long history of severe and debilitating rheumatoid arthritis for which she has had numerous treatments, but over the past ten years she has been treated with methotrexate quite successfully. Her dosage has varied somewhere between 20 and 25 mg per week. About the beginning of this year, her dosage was decreased from 25 mg to 20 mg, but because of the flare of the rheumatoid arthritis, it was increased to 22.5 mg per week. She has had no problems with methotrexate as far as she knows. She also took an NSAID about a month ago that was recently continued because of the ulcerations in her mouth. About two weeks ago, just about the time the stomatitis began she was placed on an antibiotic for suspected upper respiratory infection. She does not remember the name of the antibiotic. Although she claims she remembers taking this type of medication in the past without any problems. She was on that medication three pills a day for three to four days. She notes no other problems with her skin. She remembers no allergic reactions to medication. She has no previous history of fever blisters.