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You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: CC: 44 yo female c/o irregular periods HPI: x 3 years has had irregular periods they vary in the amount of blodd each time. Her LMP was 2 months ago and was regular. She first began to notice periods at age 14. She had flu like symptoms one week ago with nausea and vomiting. No clots during her periods. She has to use 2-3 pads when they are light and 5-6 when they are heavy. Nothing makes it better or worse. She has been experiencing hot flashes, sweating and vaginal dryness which she uses lubricant for. She also complains of dyspareunia. No fever or chills. No abdominal pain, diarrhea, constipation or urinary symptoms. PMH: HTN on HCTZ, No PSHx, No allergies, Two vaginal births without complications. FH: Mother has osteoarthritis and HTN Social: Does not smoke or use drugs drinks occasionally

vaginal dryness, dryness which she uses lubricant for irregular periods, irregular periods one week ago with nausea and vomiting, flu like symptoms one week ago female LMP was 2 months ago hot flashes vary in the amount of blodd each time, has to use 2-3 pads when they are light and 5-6 when they are heavy x 3 years sweating 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: HPI: 44 F in office c/o irregular periods x 3 yrs. Started suddenly. LMP was 2 mo's ago, menarche was 14 yo, periods last from 2-6 days, are irregular, uses 2-6 pads/tampons per day depending on flow rate, no N/V, spotting, cramping, light-headedness. 2 pregnancies resulting in 2 SVD's at term with no complications. A/w hot flashes, vaginal dryness and extra sweating. No h/o STD's or abortions or h/o dilation and curretage. Denies emotional lability, HA, CP, burning when urinating, frequency, vaginal discharge, weight gain, changes in bowel or urinary habits. ROS: negative exc as above PMH: HTN, Meds: HCTZ, NKDA PSH /Hosp / Travel / Trauma: none FH: NC SH: works as office manager, lives with husband and 2 sons, feels safe in relationship, no smoking, rare EtOH, no drugs, sexually active w/husband, no protection, no h/o STD's or abortions or dilation and curretage OB: 2 pregnancies, 2 SVD's at term, no complications

sexually active vaginal dryness irregular periods, periods are irregular F "LMP was 2 mos ago" hot flashes uses 2-6 pads/tampons per day, last from 2-6 days x 3 yrs sweating 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo F, G2P2A0, c/o irregular periods. Last menstrual period was 2 months ago. Menarche at age 14. Patient states that she has night sweats. Last pap smear was a year ago and it was normal. Patient denies any headaches, fatigue, visual changes, joint pain, abdominal pain, or SOB. Patient took a pregnancy test and it was negative. ROS- negative except for above Allergies- NKDA Meds- HCTZ PMH- HTN PSH- none SH- 1 glass of wine socially, no tobacco, no illicit drugs FH- mother with osteoarthritits and over-weight

pap smear a year ago irregular periods F Last menstrual period was 2 months ago night sweats 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms Dolores Montgmery, 44 yo F c/o Irregular menstruation that has been occuring since 3 yrs ago. Last mentruation was 2 months and was irregualar and associated with night sweats, hotflashes, and heavy flow. Pt denies cramping and clotting. On ROS - pt denies heat/cold intolerance, weight gain/loss, chest pain, headache, blurry vision or gait dysfunction. Phmx - HTN tx with HCTZ Allergy none Fhx - Mother OA and sister HTN Surg/Hosp - none Obgyn - P2G2A0, Irregular menses no defined start dates, uses 2 to 6 pads at the heaviest flow, no cramping or clots or foul discharges Shx - Office manager, No tabbacco, sociall drinker, healthy diet, and no rec drug

Irregular menstruation F Last mentruation was 2 months hotflashes 2 to 6 pads at the heaviest flow, menses no defined start dates occuring since 3 yrs ago night sweats 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 F with HTN here for irregular menses of 3 year, stating her menses come without a pattern, lasts 2-6 days, can involve minimal to heavy bleeding, no pain. She also noticed that 1 week ago she had nausea and NBNB emesis that has since resolved. She states she had hot flashes for 1 year, and 1 episode of night sweat 1 week ago, and vaginal dryness for which she uses lubricants. She took 2 home pregnancy tests, both were negative. ROS neg. LMP 2 months ago, menarche 14, regular, lasts 5 days, 2-3 tampons/day, mild cramping, denies fibroids/cyts, last Pap 1 year normal G2T2P0A0L2 PMHx: HTN PSHx: none Hospitalized for 2x vaginal deliveries Med: HCTZ NKDA FHx: Mother obesity, OA; Brother HTN SHx: never smoker, occasional drinker, no recreational drug use. Office manager, lives at home with husband & 2 sons, not stressed at home/work. Low fat & salt diet. Exercise moderately. Sexually monogamous with husband, no hx of STIs

last Pap 1 year Sexually monogamous vaginal dryness irregular menses 1 week ago she had nausea and NBNB emesis F LMP 2 months ago hot flashes menses come without a pattern, lasts 2-6 days, minimal to heavy bleeding of 3 year night sweat 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Montgomery is a 44 YOF G2P2002 with Hx of HTN here with cheif complaint of irregular periods. -Irregular periods last 3 years with cycles between 3 weeks and 4 months -Vaginal dryness, occasional hot flashes, no changes in weight -Other symptoms: episode of drenching night sweats last week, two days of N/V last week as well, no headaches, changes in vision, dysuria, diarrhea, or constipation -Meds: HCTZ -Allergies: none -Surgeries: none -FHx: mom with OA, brother with HTN -Gyn: started periods at age 14, been on copper IUDs for 20 years, last one place 4 years ago, regular 28-29 day periods up until 3 years ago -SocHx: denies smoking, reports occasional social drink at events, denies recreational drug use; sexually active only with her husband of 14 years; has 2 kids and is an office manager at an investment firm; no increased stressors

regular 28-29 day periods up until 3 years ago IUDs sexually active Vaginal dryness irregular periods F hot flashes cycles between 3 weeks and 4 months last 3 years drenching night sweats 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: HPI: 44 yo F with co irregular mentrual cycles for the past 3 years used to have her periods reularly ever 28d/5d with moderate flow and light PMS, now between 3 weeks and 4 months with very heavy to very light flow for 2-6 days. Menarche at age 14. recently started having hot flashes and excessive sweating. woke up drenched in sweat last night. uses lubricant against vaginal dryness, menarche at age 14, 2P2G, last PAP 1 y ago normal, no Hx of abnormal PAP smears. no abdomninal pain, no vaginal discharge, no weight change, no change in appetite, no change in bowel movements, no fatigue OBGYN as per HPI ROS negative except as above Allergies: NKDA FH: noncontributory PSH: none PMH: hypertension Meds: HCTZ SH: lives with husband and 2 sons, works as office manager, sexually active with husband only, uses IUD for contraception, excersis 3-4 times a week

used to have her periods reularly, used to have her periods ever 28d, used to have her periods ever 5d, used to have her periods with moderate flow PAP 1 y ago IUD sexually active vaginal dryness irregular mentrual cycles F hot flashes now between 3 weeks and 4 months, with very heavy to very light flow, for 2-6 days for the past 3 years, for 3 years sweating, drenched in sweat woke up drenched 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Montgomery 44 yo F who presents w/ irregular periods for 3 yrs. States that they are unpredictable with no pattern; lasts 2-6 days with light or heavy menstraution. LMP was 2 months ago. Patient does endorse having a copper IUD, non hormonal; last pap smear was 1 year ago and was normal. Patient denies having any abdominal pain, or changes in bowel/bladder habits; denies fevers, chills, nausea, vomiting, no changes in diet or recent sick contacts, no vaginal odors or discharge. Patient does endorse one episode of night sweats one week ago, has not had a repeat episode since then.

last pap smear was 1 year ago IUD irregular periods, periods are unpredictable, periods with no pattern Ms, F LMP was 2 months ago lasts 2-6 days, with light or heavy menstraution for 3 yrs night sweats 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: CC: irregular periods HPI: 44 y/o F G2T2P0A0L2 presents w/ 3 years of irregular periods lasting 2-6 days in length. periods are variable in length and flow, varies between light or heavy. she has had hot flashes and sweating for the past year. LMP 2 mo ago. Last saw OB/GYN 3 yrs ago, last pap smear 1 yr ago, was wnl. she has also had vaginal dryness for 1 yr, uses lubricant. ROS: denies headache, lightheadedness, fatigue, weight gain/loss, vaginal discharge/spotting, vaginal pain, NVD PMHx: HTN Meds: HCTZ Allergies: none Hospitalizations: only for birth of 2 children FHx: mom has osteoarthritis and obesity. brother has HTN. 2 healthy children. SHx: works as office manager, "loves it", married to husband, monogamous. exercises and eats healthy diet. no tobacco or drugs, social EtOH. 2 pregnancies, both term, no history o STI. uses IUD for contraception.

last pap smear 1 yr ago IUD vaginal dryness irregular periods F LMP 2 mo ago hot flashes varies between light or heavy, variable in flow, variable in length 3 years of sweating 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44 y.o. G2P2 presenting to the clinic today for irregular periods starting 3 years ago. LMP was 2 months ago. Periods previously regular, now up to 4 months apart with 2-6 d of bleeding. She experiences no pain with these periods and flow can range between heavy and light. She is sexually active and monogamous with her husband. She uses a copper IUD for contraception. She does not have increased fatigue but does report night sweats (with one particularly bad episode last week), hot flashes, and vaginal dryness that began a year ago. Denies diarrhea, constipation, heart racing, and states mood is ok today. She had flu like symptoms last week which have resolved. Births were SVD, no complications. PMH: HTN, on HCTZ Surgeries: None FH: Mom osteoporosis, Brother HTN; no hx early menopause SHx: Office manager, no current/former tobacco use, no drug use, no travel hx, occasional wine, sexually active w/ husband

Periods previously regular IUD sexually active, monogamous, sexually active vaginal dryness irregular periods flu like symptoms last week LMP was 2 months ago hot flashes now up to 4 months apart, with 2-6 d of bleeding, flow can range between heavy and light starting 3 years ago night sweats 44 y.o

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44yo G2P2 female presenting with irregular periods. Periods used to be regular at 28-29 days with moderate flow. Now they range from 3 weeks to 4 months and are "consistently inconsistent" in timing, and her flow ranges from light to heavy. She reports hot flashes and sweating recently, and a bout of PMS a few days ago with breast tenderness. She denies fatigue, headache, changes in diet or exercise. She does not have any vaginal discharge. She reports vaginal dryness over this period of time and is now using lubricant. She is monogamous with her husband and has no history of STIs. She denies urinary, bowel, digestive symptoms. PMH: HTN Meds: HCTZ Allergies: NKDA FHx: older brother HTN, mom osteoarthritis SHx: no smoking, 1 glass of wine sparingly, no drugs. Works as office manager in investment firm. denies increased stress.

Periods used to be regular monogamous with her husband vaginal dryness irregular periods female hot flashes range from 3 weeks to 4 months and are "consistently inconsistent" in timing, flow ranges from light to heavy sweating 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44yo F who presents with 3 years of increasingly irregular periods. Reports no pattern to her period, the interval between periods can be up to 8 weeks. When they occur, they can be either heavy or light. Previously, her periods occured montly, lasted 2-3 days and she used approximately 3 pads per day. Now, when bleeding is heavy, she uses around 5-6 pads. She also has been experiencing occasional hot flashes that last 1-2 minutes, they primarily occur during the day. She has noted vaginal dryness, for which she uses lubricant during sexual activity. One episode of night sweating. No vision OB/GYN: G2P2, vaginal deliveries. Menarche at 14 PMH: hypertension FH: mother with osteoarthritis and obesity, unsure when she went through menopause. Father alive and well, brother with hypertension PSH: no surgeries SH: no tobacco, no illicit drug use, occl EtOH at celebrations. Sexually active with husband, uses lubrication MEDS: HCTZ

Previously periods occured montly, Previously periods lasted 2-3 days Sexually active, sexual activity vaginal dryness, uses lubricant during sexual activity, Sexually active uses lubrication irregular periods, no pattern to her period F hot flashes interval can be up to 8 weeks, can be either heavy or light 3 years of night sweating 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms Montgomery is a 44F who presents with irregular periods. She reports that over the last 3 years her periods have become irregular and she has had variable amount os bleeding. She got her first period when she was 14 and had 28 day cycles with 3-4 days of moderate bleeding (3-4 pads/day) with mild cramping. She has had two pregnancies. Her LMP was 2 mongs ago and lasted 4 days with moderate flow. She reports that her periods over the last 2 years have been variable in flow. She notes that she has had occasional hot flashes/sweating episodes as has had one night sweat recently. She does not notice any changes in her mood. Doesn't know when her mom got her period, doesn't know sister's menstrual history PMH: HTN, meds: HCTZ SH: no drugs, occasional glass of wine, lives with husband and two kids FH: no cancer known, older brother with HTN ROS: no change in bowel habits, no change in urination, no change in mood, no headaches

had 28 day cycles with 3-4 days of moderate bleeding periods have become irregular, irregular periods F LMP was 2 mongs ago hot flashes had variable amount os bleeding, periods have been variable in flow over the last 3 years sweating episodes 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo F presenting with a 3 year histpry of irrgular periods. Her periods had previously been regular, every 4 weeks lating 4-5 days, with moderate bleeding, using about 3-4 pads a day. In the last 3 years, it had been irregular, ranging from a light period to a heavy bleed, requiring 5-6 pads a day. Her LMP was 2 months ago, with moderate bleeding. Denies any other symptoms. No excessive fatigue, double vision, changes in bowel movements, breast changes. No dysuria or dyspareunia. No abnormal vaginal discharge. Does endorse vaginal dryness, relieved with ointment. No changes in mood or irritabillity. No hot flashes. ROS otherwise negative. PMH: HTN PSH: None Meds/allergies: HCTZ Obgyn: G2P2. Normal vaginal deliveries, with no pre pr post partum compllication. Menarche at 14. regular periods until recently. Has sex with her husband. Uses IUD for protection. No dyspareunia. Endorses vaginal dryness, relieved with ointments

periods previously every 4 weeks, periods previously lating 4-5 days, periods had previously been regular, periods previously with moderate bleeding, regular periods until recently IUD, Uses IUD sex with her husband, Has sex with her husband vaginal dryness, vaginal dryness, Does endorse vaginal dryness irrgular periods, it had been irregular F, 44 yo F LMP was 2 months ago, Her LMP was 2 months ago ranging from a light period to a heavy bleed, requiring 5-6 pads a day 3 year histpry of, In the last 3 years, 3 year histpry 44 yo, 44 yo F

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: A 44 F presents with irregular periods for the past three years. She states that there is no pattern; they can last from 2-6 days and can be heavy and light reuqiring as little as 1-2 tampons or 5-6 tampons. She describes having hot flashes and sweating. She denies visual changes, nipple discharge or mood changes. Her LMP was 2 months ago and sge described it as regular (3-4 tampons a day for 4 days) Ob: Her first period was at the age of 14, her periods would occur every 28 days, last 4 days and would require 3-4 tampons per day. She also had back pain, breast tenderness, cramps. She currently denies vaginal discharge. She has vaginal dryness. She currently has an IUD. PMH: HTN on HCTZ 12.5 Sexual history: no STIs, monogamous with husband Social history: 1-2 glasses of wine. NO drugs/ smoking/ lives with her husband and son FH: osteoperosis for mom/ HTN for brother

periods would occur every 28 days, periods would last 4 days, periods would require 3-4 tampons per day, described it as regular (3-4 tampons a day for 4 days) IUD monogamous irregular periods, periods there is no pattern F LMP was 2 months ago hot flashes last from 2-6 days, can be heavy and light, reuqiring 1-2 tampons or 5-6 tampons for three years sweating 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms Montgomery is a 44 yo female who presents with a 3 year history of irregular periods. There is no pattern, the longest she has gone without a period is 4 months. Bleeding lasts 2-6 days and can be heavy or light, not related to the elapsed time between periods. Up until 3 years ago, her periods were very regular. She has noticed vaginal dryness that has been relieved with lubricant. She has also noticed hot flashes and sweating. She had one episode of drenching night sweats last month. She denies spotting between the periods, weight change, dyspareunia, and fatigue. She rarely even feels her normal PMS symptoms with periods (cramps, breast tenderness). Mood is good. Gyn history: two vaginal deliveries, no abortions, last PAP 1 year ago, normal, menarche at age 14. ROS: negative except as above Meds: HCTZ Allergies: none PMH: HTN, no surgeries SH: sexually active with husband, has IUD. Never smoker, rare EtOH, no drugs FH: HTN

until 3 years ago, periods were regular PAP 1 year ago IUD sexually active vaginal dryness, dryness relieved with lubricant periods no pattern, irregular periods Ms, female hot flashes gone without a period is 4 months, Bleeding lasts 2-6 days, can be heavy or light 3 year history of sweating, drenching sweats 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: HPI: 44F who presents with irregular periods for the past 3 years. Her last menstrual period was 2 months ago, with moderate flow (2-3 pads or tampons per day) and lasted 4-5 days. Prior to 3 years ago, she had regular periods every 28 days, which lasted 4-5 days. Her first menstrual period was at age 14. Reports hot flashes, weating and vaginal dryness and night sweats (1 week ago). Reports nausea and vomiting (nonbloody, unsure color) 1 week ago. Denies weight changes, dysmenorrhea, or spotting in between periods. Sexually active with husband with IUD as only contraception. 2 prior pregnancies, both normal sponataneous vaginal births with no complications. PMH: hypertension (diagnosed 6 years ago) PSH: none Meds: HCTZ: 12.5 mg/day NKDA FH: mom with osteoarthritis, overweight, brother: HTN SH: lives with husband and 2 sons, feels safe at home. Occupation: office manager. Alcohol: 1 glass of wine socially. Drugs/smoking: never.

Prior had regular periods, Prior periods every 28 days, Prior periods lasted 4-5 days IUD Sexually active vaginal dryness irregular periods nausea 1 week ago, vomiting 1 week ago F last menstrual period was 2 months ago hot flashes for the past 3 years, for 3 years weating, night sweats 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44 year old female who presents with a history of irregular periods. She noticed a change 3 years ago; before this time she had regular 28 day cycles that had moderate flow (of note, before each menstruation she had low back pain and breast tenderness). Over the last 3 years her periods are "unpredictable" happen every 3 weeks to 4 months, last 2 to 6 days, and the flow is anywhere from light to very heavy. She has also had occasional hot flashes and night sweats- the other day she woke up covered in sweat and decided it was time to see a doctor. She has an IUD in place- put 4 years ago. Last pap smear was 1 year ago. Denies fatigue, chest pain, SOB PMH- HTN, only hospitalization was for her 2 childbirths, no surgeries Medications- IUD, HCTZ allergies-none Family history- dad healthy, mom osteoarthritis (not sure when she started menopause) Social- no smoking, rare drinker, no illicit drug use

Last pap smear was 1 year ago IUD irregular periods, happen every 3 weeks to 4 months, periods are "unpredictable" female hot flashes flow is anywhere from light to very heavy, last 2 to 6 days Over the last 3 years, 3 years ago night sweats, covered in sweat 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44yoF presenting with irregular periods. For the past 3 years, she has experienced periods that can last 2-6 days, occur every 3 weeks to 4 months, and are sometimes light and sometimes heavy. She endorses hot flashes and vaginal dryness for 1 year, and 1 episode of night sweats last week. She has a copper IUD and is sexually active with her husband. She took 2 pregnancy tests last week and both were negative. Her old periods were predictable lasting 4 days and occuring every 28-29 days. She denies vaginal discharge. Denies dizziness, lightheadedness, changes in hair, cough, chest pain, shortness of breath, recent travel, weight gain, or weight loss. PMHx: Hypertension Surgical history: None Meds: HCTZ Allergies: None FamHx: Mother - osteoarthritis, brother - HTN, father healthy SocHx: Works as an office manager. No new stressors. No smoking. Drinks occasionally at celebrations. No drugs. ROS: Above

old periods were predictable, old periods lasting 4 days, old periods occuring every 28-29 days IUD sexually active vaginal dryness irregular periods F hot flashes occur every 3 weeks to 4 months, sometimes light and sometimes heavy, last 2-6 days For 3 years night sweats 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: This is a 44 year old female with a past medical history of HTN (taking HCTZ, presenting today with a 3 year history of irregular bleeding. Patient states that periods are unpredictable lasting any where from 2-6 days and sometimes the bleeding is light and sometimes it is heavy. Periods were regular prior to 5 years ago with moderate bleeding. Patient does endorse some vaginal dryness, some day time sweating, and one episode of drenching night sweat. She denies weight changes, fatigue, appetite changes, fever, nipple dischartge, bleeding after sex, or skin changes. Patient also denies abdominal fullness, pain or bloating. No nausea or vomiting. OBGYN: Pap smear was 1 year ago was normal. She has had two uncomplicated vaginal pregnancies. has IUD. PMH: HTN, HCTZ, no sugeries, no allergies Family: Mom has osteoarthritis and is overweight, dad is fine social: no tobacco, drinks rarely, walks 4-5 times a day, and no drug

Periods were regular prior to 5 years ago Pap smear was 1 year ago IUD vaginal dryness irregular bleeding, periods are unpredictable female lasting any where from 2-6 days, sometimes the bleeding is light and sometimes it is heavy a 3 year history sweating, drenching night sweat 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 y/o F comes in due to irregular periods that being going on for the past 3 years. She states that her periods use to be every 28 days that will ast 5 days. But now her periods range between 3 weeks to 4 months lasting between 2-6 days. She states that she also has menstraul cramping. She states that she has nausea for 48 hours with the color being her food she eat before. Pt feels hot with some sweating, but denies feeling cold. She states she experiences hot flashes. ROS: negative except above OBGYN: P2A0P2- no complications during pregnacy SH: married, has intrauterine device. sex with husband. drinks Etoh 1/3 months. denies smoking and recreational drug use. pt exercises 3/week. diet consist of meats and fruits OBGYN; G2/A0/P2

periods use to be every 28 days intrauterine device sex with husband irregular periods, now her periods range between 3 weeks to 4 months F hot flashes, feels hot going on for the past 3 years sweating 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: HPI: Dolores Montgomery is a 44 year old female with a history of hypertension who presents with 3 years of irregular menstrual periods. She relays that the interval between periods is irregular, and they last between 2-6 days, sometimes heavier with 6-7 pad changes/day, and sometimes lighter. She denies any pain or fullness in the pelvis. She has occassional breast tenderness before her periods. She denies any change in vaginal discharge or fevers. She also denies any headaches, visual changes, galactorhea, constipation, diarrhea, abdominal pain, fatigue, or cold/heat insensitivity. No significant change in weight or exercise habits. FH: HTN and obesity PMH: HTN- takes HCTZ no other meds or over the counter supplements. OB/GYN: menarche at 14 with regular periods until 3 years ago. G2P2 with 2 vaginal deliveries

regular periods until 3 years ago irregular periods female sometimes heavier sometimes lighter, sometimes with 6-7 pad changes/day, and sometimes lighter, interval is irregular, last between 2-6 days 3 years of 44 year old

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Mrs. Montgomery is a 44yo female presenting with irregular periods for the last 3 years. These range from 2-6 days in length with her cycles lasting from 3 weeks to 4 months. Her menstrual flow can be either heavy or light ranging fro 2-3 pads/day to 5-6 pads/day. Her periods are not painful. She has also had night sweats and hot flashes during this time period. She has not experienced dizziness, palpitations, intermentrual bleeding or vaginal discharge. She is sexually active with her husband (monogamous) and has no dyspurinia but does experience some vaginal dryness which she uses lubrication for. 1 weeks ago did have some nausea and vomitting for a day which resolved on its own. Denies changes in mood or energy. PMHx: HTN, takes HCTZ, no surgeries FMHX: OA, obsesity in mom and HTN in brother

sexually active, (monogamous) vaginal dryness irregular periods 1 weeks ago have nausea and vomitting female hot flashes range from 2-6 days, lasting from 3 weeks to 4 months, flow can be either heavy or light, ranging fro 2-3 pads/day to 5-6 pads/day for the last 3 years night sweats 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Dolores Montgomery is a 44yo F with h/o HTN presenting with 3 years of irregular periods. She had menarche at age 14 and had regular periods every 28-29 days with moderate flow lasting 5 days until three years ago. She has noted recent discomfort with sex due to vaginal dryness, as well as the occasional hot flashes accompanied by sweating. Her last period was 2 months ago and lighter than usual. She does have an IUD in place - this is her third IUD and she did not have any problems with the previous two. Unknown age of mother's menopause. Has had regular pap smears with no irregular results. ROS: no changes in weight, appetite, fevers or chills. - no skin dryness, hair loss, constipation Gyn Hx: 2 vaginal deliveries PMH of HTN, treated with hydrochlorothiazide; no PSH FHx: no known h/o fibroids, early menopause SHx: sexually active with husband

had regular periods, had periods every 28-29 days, had periods with moderate flow, regular periods until three years ago, periods every 28-29 days until three years ago, periods lasting 5 days until three years ago IUD sexually active, with sex vaginal dryness irregular periods F last period was 2 months hot flashes 3 years of, until three years ago sweating 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44yo G2P2 F with irregular menses. Patient reports 3 years of irregular menses. She reports that prior to 3 years ago her menses were regular, but now they have no pattern. They last from 2-6 days, occur every 3wks-4mos, and range from heavy to light bleeding. Patient reports decreased menstrual cramps. Patient denies abdominal pain, but did have some nausea and vomiting last week, thought to be food poisoning. She took two at home pregnancy tests that were negative. Patient also reports hot flashes and diaphoresis. Patient denies increased hair growth, palpitations, breast tenderness. ROS: as above meds: HCTZ; NKDA PMHx: HTN; PSHx: none OBGYN: G2P2002; uncomplicated vaginal deliveries 10 and 14 years ago; sexually active with husband, patient has an IUD (placed 4 yrs ago) FH: mom- osteoarthritis SH: investment manager; rare alcohol use, no tobacco or drug use

prior menses were regular, reports that prior to 3 years ago her menses were regular IUD, patient has an IUD sexually active, sexually active with husband irregular menses, now they have no pattern nausea and vomiting last week decreased menstrual cramps, reports decreased menstrual cramps F, G2P2 F hot flashes, also reports hot flashes They last from 2-6 days, occur every 3wks-4mos, range from heavy to light bleeding, last from 2-6 days 3 years of, prior to 3 years ago her menses were regular, Patient reports 3 years of irregular menses diaphoresis, also reports diaphoresis 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 year old G2P2 female with a history of HTN who presents with irregular periods. She has had irregular periods for the past 3 years. They have become unpredictable with no pattern, lasting from 2-6 days with an unpredictable flow. Previously, she had her period every 28-29 days, lasting 5 days, with moderate flow, with 2 days of PMS symptoms directly preceeding each period. First period at 14 yo. She has not had PMS symptoms for 3 years but with her most recent period 2 months ago, had them again. She has hot flashes with sweating 1-2 times per month and vaginal dryness. No nipple discharge. Last week, she also notes 48 hours of some kind of illness (nausea/vomiting) and woke up drenched in sweat. Other, ROS is negative. PMH: HTN PSH: None Meds: HCTZ Allergies: None FH: brother with HTN, mother with obesity and osteoarthritis and unknown when she had menopaus SH: no smoking, no drinking, social alcohol use (a few times a year)

Previously, she had her period every 28-29 days vaginal dryness irregular periods, irregular periods, unpredictable with no pattern Last week, she also notes 48 hours of some kind of illness (nausea/vomiting) She has not had PMS symptoms female most recent period 2 months ago hot flashes for the past 3 years sweating, drenched in sweat 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Mrs. Dolores Montgomery is a 44 year female who presents with irregular periods. Notes it began 3 years ago with bleeding that ranged from 2-6 days in length and from light to heavy periods. 1 year ago she started to experience hot flashes and sweating that continues to persist. Denies weight changes. and trauma She also notes vaginal dryness and discomfort during sex. Denies stressors and changes in visual fields. PMH: HTN, well controlled GH: Non-contributory Meds: HCTZ Allergies: None SHX: sexually active with her husband- 1 partner Social History: Office Manager, lives with husband and 2 sons OB/Gyn History: 2 Vaginal deliveries

sexually active vaginal dryness irregular periods Mrs, female hot flashes ranged from 2-6 days, from light to heavy periods began 3 years ago sweating 44 year

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Montgomery is a 44 yo G2P2 female ho presents for evaluation of irregular periods. Pt reports 3 yrs of irregular periods, occurring at upredictable times and lasting 2-6 days with light to heavy bleeding. She has also experiences hot flashes and sweating mostly during the day but once at night in the past year. LMP was 2 months ago lasting 4 days and associated w/ mild menstrual cramps. Previous periods were regular every 28-29 days, last 5 days with mod flow. Periods were associateed with mild PMS sx - breast tenderness, back pain, mild menstrual cramps. She is concerned about hot flashes. ROS: No fever/chillls, weight loss, headache/visual changes, nipple discharge, intermenstrual bleeding. Denies palpitations, skin and hair changes, and diarrhea/constipation. PMH: HTN. 2 vag deliv no compl, no surg FHx: HTN brother, obesity/osteoporosis mother. No cancer. SHx: Meds: HCTZ, All: NKDA SHx: No smoking, EtOH, drugs. 2 kids

Previous periods were regular, Previous periods were every 28-29 days, Previous periods last 5 days, Previous periods with mod flow irregular periods, irregular periods Ms, female LMP was 2 months ago hot flashes, hot flashes occurring at upredictable times, lasting 2-6 days, with light to heavy bleeding 3 yrs of sweating 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44 yo F presenting with irregular periods. this began 3 years ago with no precipitating factors. Her periods occur between every 3 weeks and 4 months lasting anywhere from 2 to 6 days, sometimes her flow is heavy other times it is light. Her last LMP was 2 months ago. prior to these episodes her periods were regular. She denies any remedies that make her periods more or less regular. She admits to nausea and vomiting for two days as well as hot flashes and diaphoresis for 1 year. She denies any weight gain or loss, irritability, or intermenstrual bleeding. ROS: denies headaches, vision changes, chills, CP, SOB abd pain, changes in bowel or bladder habits. allergies: NKDA meds: HCTZ x 6yrs pmhx: HTN x 6 yrs psurghx: none fhx: mother has OA and is overweight, brother has HTN shx: nonsmoker, 1 glass of wine on occasion, no drugs, office manager high stress, sexually active, no STI hx. G2P2

prior periods were regular sexually active irregular periods nausea and vomiting for two days F LMP was 2 months ago hot flashes occur between every 3 weeks and 4 months, lasting from 2 to 6 days, sometimes flow is heavy other times it is light began 3 years ago diaphoresis 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Montgomery is a 44 year old female complaining of irregular periods. The change is her periods began approximately 3 years ago, and they have been unpredictable in terms of their onset and duration. Her last menstrual period was 2 months ago. When they do occur, they range from 2-6 days and range from low to high flow. In the past, she has had menstrucal cramps and breast tenderness, but has not had these symptoms consistently over the last few years. but they did occur during her last period. She denies any weight change, nipple discharge, or mood changes., but endorses experiencing hot flashes, sweating, and an episode of night sweats. Sexual history: 2 prior pregancies, full term, with no complications. Has Intrauterine device for contraception. Denies discharge Med hx: HTN, controlled with HCTZ Family hx: no pertinent family history No prior surgeries, or allergies No drug, tobacco use

Intrauterine device irregular periods, change is her periods, periods have been unpredictable had menstrucal cramps and breast tenderness, but has not had these symptoms Ms, female last menstrual period was 2 months ago hot flashes periods unpredictable in terms of their onset, periods unpredictable in terms of their duration, range from 2-6 days, range from low to high flow began 3 years ago sweating, night sweats 44 year old

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44yo F with hx of irregular periods for 3 years. - Menstrual history: Menarche at 14yo. Cycle 28-29 days. Mentrual period would typically last for 5 days, require 2-3 pads daily. With mild PMS symptoms including cramps, breast tenderness, low back pain. - In the past 3yrs, menstrual periods have occurred without pattern, from 3wks apart to 4mo apart. Flow is very light to heavy, lasting 2-6 days. Now without PMS symptoms except for in the most recent period. LMP 2 months ago. - Also with occassional hot flashes and sweating - Denies palpitations, hair loss, weight changes, fevers, chills - IUD in place ROS: as per HPI PMH: HTN Meds: HCTZ NKDA. No prior surgeries. Hospitalizations for childbirth x2. FHx: Brother with HTN. Mom overweight, with osteoarthritis. SocHx: Office manager. Never smoker. Rare alcohol use. Denies recreational drugs. Sexually active with husband only. Normal mammogram last year

Cycle 28-29 days, period would typically last for 5 days, period would typically require 2-3 pads daily IUD Sexually active irregular periods, periods occurred without pattern without PMS symptoms F LMP 2 months ago hot flashes from 3wks apart to 4mo apart, Flow lasting 2-6 days, Flow light to heavy for 3 years, In the past 3yrs sweating 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Montgomery is a 44 yo F who presents w/ 3 years of irregular periods. She began menses at 14 years old and was regular (menses q.28-29 days, lasting 5 days, moderate flow with 3-4 pads and mild PMS sxs including breast tenderness, lower back pain and mild pelvic cramping without mood changes). However, over the past 3 years, her periods became irregular, beginning unpredictably, and ranging from light to heavy relative to her baseline moderate flow. She has had one episode of her normal PMS sxs over the past 3 years and that was prior to her LMP which was 2 months ago. Endorses occasional hot flashes and diaphoresis that begin and conclude spontaneosly ROS: no changes in skin, hair, bowel habits, weight, appetite, energy levels since her menstrual irregularities began. No CP, SOB. PMHx: HTN, G2P2. Meds: Copper IUD in place, HCTZ. NKDA. Sexual hx: monogomous w/ husband. Family hx: HTN in her brother, mother: obesity, osteoarthritis

menses was regular, menses q.28-29 days, menses lasting 5 days, menses moderate flow with 3-4 pads, baseline moderate flow IUD monogomous irregular periods, periods became irregular, menstrual irregularities Ms, F LMP was 2 months ago hot flashes beginning unpredictably, ranging from light to heavy 3 years of, over the past 3 years diaphoresis 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo F c/o irregular menstrual period 3 yrs PTA-less flow LMP:3 yrs ago - OB/GYN: LMP 3 yrs ago, previously regular 5 days*28-29 days, G2P2, no complication, vaginal delivery, vaginal dryness->dyspareunia-needs lubrication -Reports: cramps with menstruation, back pain, sleeping -Denies:irritable mood, edema, constipation, diarrhea, palpitation, vaginal dis -PMH: HTN 6 yrs ago on HCTZ, no Sx -FH:noncontributory, cannot recalls mother menopause age SH: works as an office manager in invesment firm, occasional EtOH, no illicit drug use, no smoking, monogamous with husband, healthy diet, regular exercise

previously regular, previously 5 days, previously *28-29 days monogamous vaginal dryness, dyspareunia-needs lubrication irregular menstrual period F 3 yrs PTA 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44F with HTN presesing for irreuglar periods for past 3yrs. They occur every 3wk-4mo and she bleeds 2-6d (heavy or light). previously they occured every 28-29d and lasted 5d. LMP was 2 months ago whcih was normal and she has no spotting since then. Endorses hot flashes and vagnal dryness with sex for one year. Had one episode of night sweats last week and also had nausea and vomiting for a few days. Denies weight loss, fevers or chills, headaches, bowel changes or urinary changes. No STDS in past. G2P2. took home pregnance test whishcwere negative. Denies vaginal discharge, breast discharge. pmh- HTN psh- none med- HCTZ all- none fh- mop- OA, brother htn SH- lives at home with husband and 2 children, rare drnker, deneis drugs or tob

previously occured every 28-29d, previously lasted 5d, previously they occured every 28-29d and lasted 5d with sex vagnal dryness, Endorses vagnal dryness irreuglar periods, presesing for irreuglar periods nausea and vomiting for a few days F, 44F LMP was 2 months ago hot flashes, Endorses hot flashes occur every 3wk-4mo, bleeds 2-6d, bleeds (heavy or light, lasted 5d for 3yrs, irreuglar periods for past 3yrs night sweats, Had one episode of night sweats 44, 44F

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44yo Female presents with irregular period. -Menarche has irregular pattern. Started 3 years ago. Menarche last 2-6 days, irregular flow and consistency. -Pt also experiences hot flashes and sweating. -Pt denies hair loss, hair gain, heart palpitation, cold/heat intolerance, fever, and chills, abdominal pain, stool changes. PMH: HTN NKDA, meds include HTCZ Hospitalize for childbirth 10 and 14 years ago. Pt works in office Finance investing. LMP was 2 months ago. Requires 3-4 pads. No changes in urination/defaction/diet/weight. Sleep changes wakes up early past 3 months. FMh: Older Brother has HTN, mother is overweight and has osteoporosis. No tabacco, rarely drinks, no drugs Sexually active with husband. Pt has IUD.

IUD Sexually active irregular period Female LMP was 2 months ago hot flashes irregular flow and consistency Started 3 years ago sweating Sleep changes, wakes up early 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 year old female c/o irregular periods. Patient states that she has a history or regular periods since menarche at age 13 up until 3 years ago when she began having unpredictive, irregular periods. Menstraution last 2-6 days and can be heavy to light flow. Patient does report hot flashes throughout day for the past year and a recent episode of nt seats last week. She denies any weight changes, hirsutism, cold intolerance, changes in hair, dysmenorrheapalpitations or change in energy OBGYN: G2P2. Mearche at age 13, LMP 2 months ago. Previously regular periods till about 3 years ago. ROS: Negative except for above Medications: HCTZ Alllergies: None PMH: HTN, treated with HCTZ and DASH diet PSH: None SH: Occasional EtOH, no tobacco or illicit drug. Lives with Husband. Eats a healthy balanced diet and walks 3-4 times a week. Monogomous with husband. FH: Mother obese and oseteoarhtrits

regular periods since menarche, Previously regular periods Monogomous with husband irregular periods female LMP 2 months ago hot flashes heavy to light flow, last 2-6 days 3 years ago 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 year old female who presents with 3 years of irregular periods. Previously regular, her periods are now anywhere from 2-6 days, light to heavy. She is now experiencing hot flashes and sweating. Has had PMS symptoms for the first time in 3 years to include breast tenderness, low back pain, and menstrual cramping. Also last week had 48 hours of flu-like symptoms to include nausea and vomiting. No changes in bowel or bladder habit. She is sexually active her husband, but has a copper iud that was placed 4 years ago with no change in periods at that time. Has a PMH of HTN for which she takes HCTZ. No history of surgeries. Hospitalized twice for the birth of her 2 sons. No abortions or miscarriages. No family history of irregular periods, blood disorders or thyroid disorders. Denies tobacco use or recreational drugs. Drinks very infrequently 1 glass of wine at a time.

Previously regular iud sexually active irregular periods last week had 48 hours of flu-like symptoms female hot flashes anywhere from 2-6 days, light to heavy 3 years of sweating 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44 yo F c/o irregular periods for the past 3 years. They vary from every 3 weeks to every 4 months. She has had associated night sweats, trouble sleeping, and hot flases well during this time. She denies chest pain, vaginal discharge, vaginal bleeding, palpitation, sensitivity to cold, skin changes, decreased libido, vision changes, dysuria, hair thinning/loss, and weight changes. ROS: negative except for above Ob/Gyn: 2 uncomplicated pregnancies. Vaginal deliveries. Has a copper IUD in place for contraception. Last pap smear was 1 year ago. Has had normal pap smears throughout life. PMH/PSH: HTN. had gastroenteritis that caused N/V but resolved on its own within 48 hrs. Allergies: NKDA Meds: HCTZ FH: Arthritis in mom and brother with HTN Sexual hx: monogamous with husband. no hx of STD's SH: never smoked, denies illicit drug use. Rarely drinks alcohol. Feels safe at home.

Last pap smear was 1 year ago IUD Sexual hx: monogamous with husband irregular periods had gastroenteritis that caused N/V but resolved on its own within 48 hrs F hot flases vary from every 3 weeks to every 4 months for the past 3 years sweats trouble sleeping 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44yo F with HTN who presents for evaluation of 3 years of irregular periods. Pt reports that her periods have been unpredictable, lasting 2-6 days, with variable flow. Prior to the irregularity, her periods were regular, lasted 5 days, with moderate flow and mild pain. She denies any pain with intercourse but states that she has experienced vaginal dryness for about a year. One week ago, she woke up drenched in sweat. She also reports that a week ago, she experienced nausea and vomiting for 2 days. Pt has been using copper IUD for 20 years, last replaced 4 years ago. No hx of STDs or HIV. Normal pap smear 1 year ago. ROS negative other than HPI PMH: HTN Meds: HCTZ NKDA PSH: none FH: mom with osteoarthritis and overweight, brother with HTN SH: lives with husband and 2 sons (ages 10 and 14), works as office manager, no smoking/alcohol/drugs, low fat low salt diet, walks 3-4x/week

periods were regular pap smear 1 year ago IUD vaginal dryness irregular periods, periods have been unpredictable a week ago, she experienced nausea and vomiting F with variable flow 3 years of drenched in sweat 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 YO F IN CLINIC C/O IRREGUALR PERIOD X 3 YO. SUDDEN ONSET. HER LMP 2 MO AGO, 4 - 2 MO INTERVAL , SOMETIMES 3 WK INTERVAL , LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT . MENERCHE AT 14.A/W VAGINAL DRYNESS, SLEEP DIFFICULTY, SHE WAKES UP EARLY IN A.M. SHE HAS SOME STRESS . DENIES IRRITABILITY, MOOD CHANGE , FEVER. NO WEAKNESS, URINARY OR BOWEL HABIT CHANGE. PMH FLU LIKE ILLNESS 1 WK AGO, HTN X 6 YO , NKDA, MEDS HCTZ X 6 PSH / HOSP / TRAVEL / TRAUMA NONE FH N/C OB / GYN HER LMP 2 MO AGO, 4 - 2 MO INTERVAL , SOMETIMES 3 WK INTERVAL , LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT . MENERCHE AT 14., G2P2 SH OFFICE MANAGER, NO TOBACCO / REC DRUG, ETOH OCC SEXUALLY ACTIVE W/ HUSBAND

SEXUALLY ACTIVE VAGINAL DRYNESS IRREGUALR PERIOD FLU LIKE ILLNESS 1 WK AGO F HAS SOME STRESS LMP 2 MO AGO, LMP 2 MO AGO LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT, LASTS FOR 2 -6 D, FLOW HEAVY TO LIGHT X 3 YO SLEEP DIFFICULTY, WAKES UP EARLY 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery, a 44-year-old female, c/o irregular periods. LMP 2months ago, lighter/shorter duration than previously, previously q28days. Associated with vaginal dryness, breast tenderness, dysmennorhea. Pt eats healthy and exericies. ROS: Denies postcoital bleeding, dysparenuia, hirtuisum, cold/hot intolerence, change in BM, abdominal pain, change in weight/appeitie, change in urination, skin changes, OBGYN: G2P2, SVD, no complication, IUD 4years ago, menarche 14 PMH: HTN, well controlled Meds: HCTZ PSH:none Allergies: NKA SHx: EtOH occacionally, denies smoking, illicit drug use, officer manager, sexualy active with husband only FH: Brother HTN, Mother osteoarthritis

previously q28days IUD sexualy active vaginal dryness irregular periods female LMP 2months ago lighter/shorter duration than previously 44-year-old

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: PT IS A 44 Y/O f W/ CHIEF COMPLAINT OF IRREGULAR PERIODS. PT STATES THAT FOR THE PAST 3 YEARS SHE HAS BEEN EXPERENCING UNPREDICTABLE PERIODS. PT STATES PREVIOUSLY SHE HAD REGULAR PERIODS EVERY 28 DAYS WITH 5 DAYS OF LIGHT BLEEDING. Now, pt is experiencing irregular periods w/ bleeding lasting 2-6 days sometimes bleeding through multiple pads, sometimes light. Pt is also experiencing what she describes at hot flashes and sweating. Pt denies nipple discharge or headaches. OBHX G2P2 woman with 2 healthy kids born at full term via normal spontaneous vaginal delivery, no complications. Pt is sexually active w/ husband, no concern for STDS, no hx of stds, last PAP 1 year ago no abnormalities. No pain with intercourse. Pt complains of vaginal dryness and discomfort which she treats with lubricant. PMH: HTN PSH: none allergies: none Meds: HCTZ FH: mother: osteoarthritis Social: lives at home with husband no complaint -ETOh, -T

PREVIOUSLY SHE HAD REGULAR PERIODS, HAD REGULAR PERIODS EVERY 28 DAYS sexually active vaginal dryness IRREGULAR PERIODS, irregular periods f hot flashes UNPREDICTABLE PERIODS, bleeding lasting 2-6 days sweating 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 3 year history of irregular menses. Pt has a copper IUD for 4 years, non hormonal. Periods last 2-6 days and are at intervals of 3wks-4months. Flow ranges from heavy to light. No pattern or associations between length of periods and flow. She does not usually have symptoms of cramping, back pain, or breast tenderness, but she had these before her most recent period 1 week ago. 2 children, vaginal deliveries at age 30 and 34, no problems during pregnancy. Sexually active with husband only. No vaginal discharge, itching or pain. Occasional vaginal dryness. No history of STIs.Denies dyspareunia, dysuria, or bowel changes. Denies headache or fever. 2 days of vomiting last week associated with abdominal cramping. Denies abdominal pain. No hospitalizations or surgeries. PMH: hypertension Meds: HCTZ FHx: no family history of early menopause or painful menses

IUD Sexually active vaginal dryness irregular menses does not usually have symptoms of cramping Periods last 2-6 days, are at intervals of 3wks-4months, Flow ranges from heavy to light, No pattern flow, No pattern length of periods 3 year history

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 year old female presenting with chief complaint of irregular periods - ongoing for the past 3 years, reports irregular periods, coming at unpredictable times, lasting anywhere from 2 to 6 days, flow is variable ranging from light to heavy - reports nothing has made her symptoms better or worse; have been stable in unpredictablility over the 3 years - last period 2 months ago - periods prior to 3 years were normal Review of systems: no fevers, chills, chest pain, shortness of breath, abdominal pain, diarrhea/constipation, dry skin, dysuria PMH: hypertension, no surgeries Medications: HCTZ NKDA Social: office manager, rarely drinks alcohol, no drug use or smoking, sexually active with husband 20+ years ObGyn: menarache at 14, regular periods every 28-29 days, lasting 5 days, moderate flow, would also get breast tenderness, cramps with periods, G2P2 (two sons 10, 14) no oral contraceptive use, no hormone replacement therapy

periods prior to 3 years were normal sexually active irregular periods, irregular periods female last period 2 months ago flow is variable ranging from light to heavy, coming at unpredictable times, lasting anywhere from 2 to 6 days ongoing for the past 3 years 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: CC: irregular periods HPI: 44 yo F presenting to the clinic with irregular periods since 3 years. Menstrual cycles have lasted various lengths of times. Associated sx include hot flashes, breast tenderness, PMS, and one episode of lower back pain. Pt has not seen any clots in her menstruation. Pt currently is using an IUD which was placed by her gynecologist but is currently seeing her primary care for her GYN care. Mammograms and Pap smears have been all normal. Denies headaches, dizziness, chest pain, SOB, abdominal pain, dysuria, NVDC, fevers, night sweats, weight loss. PMH: HTN PSH: None Meds: HCTZ Fam: Brother has HTN, mother has osteoarthritis Allergies: NKDA Social: Pt is happily married and lives with her family. Drinks wine only on social occasions. Denies smoking, illicit drug use, recent travel. Sexually active with husband and she uses an IUD

IUD, IUD Sexually active irregular periods, irregular periods F hot flashes lasted various lengths of times since 3 years night sweats 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44 yo F with irregular periods for the past 3 years. She describes them previously as very regular 28-29 days, medium flow, lasting 5 days, preceded by breast tenderness, lower back soreness and cramps. 3 years ago, these became unpredictable with no pattern, 2-6 days in length, bleeding could be light to heavy, without typical PMS symptoms until once recently. She notes 1 year hot flashes, sweating, vaginal dryness needing lubricant, 1 night last week of drenching night sweats. No changes to energy, weight, appetite. Rest of ROS neg PMHx: HTN diagnoses 6 years ago, well controlled PSHx: None Medications: HCTZ. IUD in place Allergies: None FH: Older brother HTN, mom overweight osteoarthritis. SH: Office manager. Lives with husband and 2 sons, feels safe at home, sexually active, IUD replaced 4 years ago, used for 20 years. No prior STIs. No tobacco, illicit drugs. EtOH extremely rarely, 1-2 drinks/mos

previously regular, previously 28-29 days, previously medium flow, previously lasting 5 days IUD, IUD sexually active vaginal dryness, dryness needing lubricant irregular periods, became unpredictable without PMS symptoms F hot flashes 2-6 days in length, could be light to heavy for 3 years, 3 years ago sweating, night sweats, drenching sweats 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Patient is a 44 year old female presenting with a three year history of irregular menstruation. Patient's last menstrual period was two months ago. Periods last 2 - 6 days, however patient reports that this varies. Also reports using 5 to 6 pads when periods are regular but fewer than this during light periods. Patient reports hot flashes and sweating along with vaginal dryness. Has two previous pregnancies (spontaneous vaginal delivery). Menarche 14y. Reports nausea and vomiting one week ago. Reports that she took a pregnancy test which was negative ROS: no cramps, no vaginal discharge, no history of STIs no weight gain, no appetite changes, no visual disturbance. Allergies: none Medications: HCTZ (compliant with medications) PMH: HTN for six years PSH: no surgeries FH: mother had oesteoarthritis SH: works as an office manager, ETOH (glass of wine) on special ocassions, no tobacco or drug use, sexually active with husband only.

sexually active vaginal dryness irregular menstruation female last menstrual period was two months ago hot flashes Periods last 2 - 6 days, reports using 5 to 6 pads when periods are regular but fewer than this during light periods a three year history of 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Montgomery is a 44 yo F w/ irregular periods. She has been having irregular periods for the past 3 years. Periods have been very unpredictable with no consistent pattern. When she has periods, she can bleed for 2-6 days and the flow may be light or heavy. Her last menstrual period was 2 months ago, and she had some pain menstrual cramping for 2 days prior. She has also been having nausea with 3 episodes of non-bloody non-bilious vomiting last week, vaginal dryness, discomfort during sex, hot flashes, diaphoresis and 1 episode of night sweats last week. PMH: HTN diagnosed 6 years ago PSH: None Allergies: NKA Medications: Hydrochlorothiazide FH: Brother: HTN, Mom: Obesity, arthritis, Dad: Healthy SH: Works as office manager, sexually active with husband, rare EtOH use, no history of tobacco or drug use ROS: + Nausea, vomiting, vaginal dryness, hot flashes, diaphoresis, night sweats NO Irritability, chest pain, SOB, headache

sexually active vaginal dryness, vaginal dryness irregular periods, Periods have been very unpredictable vomiting last week F last menstrual period was 2 months ago hot flashes, hot flashes can bleed for 2-6 days, flow may be light or heavy for the past 3 years diaphoresis, night sweats, diaphoresis, night sweats 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo F with a history of controlled HTN here with irregular periods for 3 years. Periods have been irregular and unpredictable, with menses lasting 2-6 days with variable light to heavy flow. Menarche was at age 14, and menses were previously regular every 28-29 days with moderate flow and predictable premenstrual symptoms (abdominal pain, bloating). No history of sexually transmitted infections. ROS: Endorses episode of night sweats, vaginal dryness x 1 year. Denies headaches, vision changes, tremors, abdominal pain, peripheral edema, breast pain, discharge PMH: HTN, controlled. PSH: None FH: No known menstrual irregularities. Mother's age of menopause unknown. Brother has HTN. Mother was overweight , OA. Meds: HCTZ 12.5 mg/d x 6 years Allergies: None SH: Never smoker, rare alcohol consumption, never illicit drug use, walks 3-4 times per week. Healthy low fat, low salt diet. Has 2 childrenNo change in mood. No acute stressors

menses were previously regular, previously every 28-29 days, previously with moderate flow vaginal dryness irregular periods, Periods have been irregular, Periods have been unpredictable F menses lasting 2-6 days, variable light to heavy flow for 3 years night sweats 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Pt is a 44 yo female with increasingly unpredictable periods. Her periods were regular, occurring every 28 days, lasting 5 days with moderate abdominal cramping. Her periods are now irregular and lasts 4-6 days with light to heavy bleeding. She is experiencing hot flashes and sweating and some discomfort due to vaginal dryness that is relieved with lubrication. She has no significant gynecological history, has had 2 prior pregnancies with no complications. She is experiencing no joint pain or fatigue. She has had no weight loss or gain. Allergies: NKA Meds: HCTZ PMH: HTN PSH: none FH: older brother with HTN, mom with osteoarthritis SH: works as an office manager, does not smoke or use illicit drugs. Drinks rarely 1-2 glasses a month. Exercises by walking 3x a week. Is sexually active with husband.

periods were regular, periods were occurring every 28 days, periods were lasting 5 days sexually active vaginal dryness unpredictable periods, periods are now irregular female hot flashes periods with light to heavy bleeding sweating 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 YO F with 3 years of irregular periods. Patient reports getting her period at age 14 and having regular periods up until 3 years ago when they became unpredictrable. Periods now last from 2-6 days, her flow has alternated. She had one epidose of cramping and premenstrual symptoms on her last period. She has regular pap-smears and they have always been negative for any abnormalities. She is G2P2, both vis SVD without any complications, she is seually active only with her husband. Patient recalls having a few episodes of night sweats and hot flshes, but denies any changes in her mood or ability to concentrate. No urgency, frequency or dysuria. PMHx: Hypertension PSHx: None FH: Brother with hypertension, mother with osteoarthritis. Meds: HCTZ Allergies: NKDA Gyn: G2P2

regular periods up until 3 years ago seually active irregular periods, they became unpredictrable F hot flshes flow has alternated, last from 2-6 days 3 years of night sweats 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: HPI= 44yo F c.o irregular period, x 3yrs, worse w/nothing, better w/ nothing. Before 3yrs ago, Her cycle was 25-28days, duration was range from 4-5days, with moderate flow. Current cycle range from 3weeks- 2mos, duration range from 2-6days, flow range from light to heavy. On a heavy days, she uses 6-7pads/day. She also has vaginal discomfort during sex, so that she uses lubricant. She has PMS symptom, Lower back pain, SOB, Hot flashes, sweating 1-2x /mos. She is sexually active with her husband. She denies spotting/ mood change/ dyspareunia/ STD hx/ weight change/ breast discharge. ROS= negative except as above PMH= no similar episode, HTN x6yrs. Allergy= NKDA Meds= HCTZ x6yrs. FH= mother overweight, father healthy Ob/Gyn as in HPI G2P2A0 SH= no cigs. Etoh 2,3times/year. no rec drugs.

Before cycle was 25-28days, Before cycle range from 4-5days, Before cycle with moderate flow during sex, sexually active vaginal discomfort uses lubricant irregular period F Hot flashes Current range from 3weeks- 2mos, duration from 2-6days, flow range from light to heavy x 3yrs sweating 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Montgomery is a 44 y.o F that presents with irregular preiods for the past 3 years. She has always had regulr periods in the past (28-29 day interval, moderate flow, mild cramps, breast tenderness, LBP a few days before) but since 3 years has had unpredictable patterns 2-6 days flow from light to heavy periods. Last period was 2 months ago and had premenstrual symptoms then as well. She also had hot flashes, sweating symptoms recently and last obgyn vist was a year ago with nml papsmear and no STDS in the past. She has a stomach flu symptoms 2 days last weeks with associated vomiting and went away on its own. Denies any feverm n, vomiting bowel bladder issues, cold/heat intolerance. Meds: HCTZ/ allergies Allergies: none Fhx: Father has HBP, mother obestiry and OA Shx: Married 20 years, 2 kids, in home PMH: 2 pregancies both baginal

always had regulr periods in the past a year ago papsmear irregular preiods has a stomach flu symptoms 2 days last weeks F Last period was 2 months ago hot flashes has had unpredictable patterns, 2-6 days, flow from light to heavy for the past 3 years, since 3 years sweating 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo R presenting with irregular periods for 3 years. LMP was weeks ago, gets period in irrgeular intervals, lasts 2-6 days, sometimes heavy (5-6 pads/day) or light. Not associated with pain. Of note, sexually active exclusively with husband, uses copper IUD as contraception, 2 negative pregnancy tests at home last week. Last PAP smear last year that was normal. Last seen by OBGYN 3 years ago. No PMH of fibroids, cysts, polyps, bleeding disorders, endocrinopathies, GYN malignancy. No FH of bleeding disorders, GYN malignancy. Unsure of age of menopause in women of family.

IUD sexually active irregular periods gets period in irrgeular intervals, lasts 2-6 days, heavy or light for 3 years 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 y/o female with history HTN who prsents with irregular bleeding over the last several years. Her periods are irregular with no predictable pattern, sometimes heavy or light, last from 2-6 days. Last period 2 months ago, normal. Menarche age 14, regular at that time. 2 sons aged 14 and 10, no pregnancy complications, vaginal birth. Hasn't seen gynecologest for 3 years as they retired. Also noticed drenching night sweats last week, vaginal dryness requiring lubricant for intercourse, hot flashes, early morning wakenings several times over the last several months. Denies vaginal discharge, pain with urination or intercourse. Sexually active with husband only. She does note an illness 1 week ago with nausea and vomiting that lasted two days. Family history significant for overweight, hypertension. No weight changes, changes in mood, changes in bowel habits, abdominal pain.

Sexually active vaginal dryness, requiring lubricant for intercourse irregular bleeding, periods are irregular, periods with no predictable pattern 1 week ago with nausea and vomiting female Last period 2 months ago hot flashes sometimes heavy or light, last from 2-6 days over the last several years night sweats, drenching sweats early morning wakenings 44 y/o

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: The patient is a 44 yo F who came in due to irregularity in her menstruation. This started 3 years ago and the pattern has been unpredictable and irregular. Flow varies from light (1-2 pads a day), moderate (3-4 pads a day) or heavy (up to 6 pads a day). The patient has experienced one episode of menstrual cramps. There is associated hot flashes, sweating, sleeping problem (wakes up early and unable to fall back to sleep) and vaginal dryness for the past few months. Her last menstrual period was 2 months ago. She denies any mood changes, changes in her skin or hair, chest pain, headache, dyspnea,changes in bowel movement or urination. OB hx: G2P2. Both vaginal deliveries with no complications ROS: Neg except as above PMH: HTN for 6 years PSH: None Meds: HCTZ FH: Mother has osteoarthritis. Brother has HTN. SH:Office manager.Drinks occasionally.No smoking and drugs. Low fat low salt diet.Sexually active with husband. Uses lubricant

Sexually active vaginal dryness irregularity in her menstruation, pattern has been unpredictable, pattern has been irregular F last menstrual period was 2 months ago hot flashes Flow varies from light moderate or heavy, Flow varies from 1-2 pads a day 3-4 pads a day up to 6 pads a day started 3 years ago sweating sleeping problem, wakes up early, wakes and unable to fall back to sleep 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44 year old previously healthy female who presents to clinic to discuss irregular periods. States this has been going on for the past 3 years. LMP was 2 months ago and lasted 4 days. Describes tenderness, low back pain, and cramping prior to this period. Also endorses hot flashes, sweating, and vaginal dryness over the past year. Dryness has improved with estrogen cream. Denies hx of STDs. Is sexually active with her husband. Has Copper IUD which was placed 4 years ago. Denies weakness, weight changes, fevers, chills, lower extremity edema, or cardiac problems. MEds: HCTZ Allergies none PMH HTN PSH none OB 2 pregnancies normal vaginal delivery FH: does not know family menstrua hx SH: Office manager. Lives w/ husband. Denies smoking, drug use. occassional champagne

IUD sexually active vaginal dryness irregular periods female LMP was 2 months ago hot flashes for the past 3 years sweating 44 year old

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yof with history of irregular menstrual bleeding. Last period 2 months ago. lasted 4 days and used 2-3 pads daily. Before that last period was 3 weeks before and lasted 5 days with 5-6 pads daily. And before that last period was nother 4 months. Before irregular periods started, patient normally had period every month lasting 5 days and used 2-3 pads daily. She denies any headache, fever, chills, vision changes, fatigue, galactorrhea, pain with sex (although mentions vaginal dryness). Meds: HCTZ. No known drug allergies. FH. mom w/ osteoarthritis nad brother with hypertension. Social Hx: Denies tobacco, social alcohol, no recreational drug use. Surgical history: 2 vaginal deliveries. PMH: hypertension. Denies any history of STDs, abortion, is sexually active with jsut her husband, and this has never happened before

Before normally had period every month, Before normally had period lasting 5 days, Before normally had period used 2-3 pads daily with sex, sexually active vaginal dryness irregular menstrual bleeding, irregular periods f Last period 2 months ago 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44 yof c/o irregular periods. Meses in past have been regular every 28-29 days, lasting 5 days with moderate flow, mild PMS symptoms of breast tenderness, back pain, and mild cramping. Menses for past 3 years have become unpredictable in pattern lasting 2-6 days with light to heavy flow. Patient has also been experiencing hot flashes and sweating, vagina dryness, and discomfort during intercourse during past year and woke drenched in sweta for 2 days last week. Denies weight change, fatigue, palpitations, abdominal/pelvic pain, vaginal discharge, skin changes, or hair growth. OBGYN: G2P2 normal pregnancies full term. ROS: otherwsie negative Allergeis: none Meds: HCTZ PMH: HTN PSH: none FH: older bother HTN, mother osteoarthritis, overweight SH: lives with husband and 2 sons, monogmaous sexually active with husband, rare alcohol, no tobacco,no recreational drugs. works as office manager.

Meses in past have been regular every 28-29 days sexually active vagina dryness irregular periods yof hot flashes lasting 2-6 days, light to heavy flow, unpredictable in pattern sweating, drenched in sweta 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 YO G2P2 female with irregular periods - patient reports a 3 year history of irregular periods (no pattern to occurence, 2-6 days in length when they do occur, light-heavy flow) - her previous menstrual history was regular, every 28-29 days, and moderate flow - she also experienced occasional breast tenderness, mild cramps before her periods which disappeared when her periods became irregular but returned last week - does not know when mother had menopause - LMP: 2 mo ago, has a copper intrauterine device placed 4 yo ago w/o complications, had 2 uncomplicated term pregnancies - patient is sexually active with her husband and does not use condoms - does not smoke and uses alcohol socially, no other drugs - takes HCTZ for hypertension, NKDA - in addition, she reports occasional hot flashes/sweats which interrupt her sleep, menstrual cramps, and nausea - she denies any diarrhea, irregular uterine bleeding, chest pain

previous menstrual history was regular, previous menstrual history was every 28-29 days, previous menstrual history was moderate flow intrauterine device sexually active irregular periods, irregular periods, periods (no pattern breast tenderness, mild cramps before her periods disappeared when her periods became irregular female LMP: 2 mo ago hot flashes 2-6 days in length, light-heavy flow 3 year history of sweats interrupt her sleep 44 YO

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery, a 44-year-old female, has come to the doctor's office today to discuss her irregular periods. - Has been having irregular periods for the past three years - periods have been unpredicatble , they have been heavy and light, last two to six days - two months ago has experienced hot flashes with sweating -has been getting up earlier 4-5x in the past three months - currently sexually active with husband, no barrier protection, has iud - has hypertension -has had breast tenderness, back pain and one episode of menstrual cramps -no skin changes

iud sexually active irregular periods, irregular periods, periods have been unpredicatble female hot flashes they have been heavy and light, last two to six days for three years sweating has been getting up earlier 4-5x in the past three months 44-year-old

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 y/o F w/ 3 year h/o irregular periods. Patient previously had regular 28-day periods w/ regular flow onset of menses at age 14. No h/o pelvic pain, abnormal bleeding before. Patient c/o irregular flow (heavy/light) and hot flashes, sweating, and one episode of night sweats. She also endorses 1 episodes of N/V. She denies and F/C, recent travel, abnormal exposures, or h/o STDs. She is sexually active w/ husband only. PMH: HTN PSH: none Meds: HCTZ All: none FHx: none SHx: no smoking, social drinker ROS: as per HPI, o/w neg Women's health: Regular PAP, most recent 1 year ago, all normal

previously had regular periods, previously had 28-day periods, previously had regular flow PAP 1 year ago sexually active irregular periods F hot flashes irregular flow, flow (heavy/light w/ 3 year h/o sweating, night sweats 44 y/o

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44yo F coming in for irregular periods of 3yr duration. Periods occur anywhere from 3 weeks-4 months apart, and last for 2-6 days, with variable bleeding from 1-6 pads per day. No triggers. She has had 2 pregnancies with uncomplicated vaginal deliveries. She used to have pain/cramping when she had regular periods but does not have any pain with periods anymore. She reports hot flashes and sweating. Her menarche was at 14, LMP 2 months ago. Mother's age at menopause is unknown. Has used IUD for 20 years, last insertion was 4yo. PMH: HTN on HCTZ. No hospitalizations other than childbirth. No surgeries, no allergies Family hx: Mother has osteoarthritis, obesity. Brother has HTN. Social: lives with husband and 2 children, works as office manager. Sexual: active with husband. Birth control is IUD. No hx of STIs. Reports dyspareunia and vaginal dryness, uses lubricant. Never smoker, alcohol rarely, no drugs

when she had regular periods IUD, IUD Sexual: active vaginal dryness irregular periods does not have any pain with periods F LMP 2 months ago hot flashes occur 3 weeks-4 months, last for 2-6 days, variable bleeding, from 1-6 pads per day of 3yr, 3yr duration sweating 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44-year-old female, has come to the doctor's office today to discuss her irregular periods. Periods have been irregular for 3 years, lasting between 2-6 days, alternating between heavy and light changing 5-6 pads for heavy days with no spotting between periods and no pain. Menarchy was at age 14, periods were regular 28 day cycles with 2-3 days of moderate flow for 5 days changing 2-3 pads. Patient reports hot flashes, and one episode of night sweating. She also reports vaginal dryness during sex for which she uses lubricant. No recent weight changes, skin changes, trauma, infections. No masses/lumps in the neck. No feelings of sadness or fatigue. 2 pregnancies to term, no abortions/misscarages. ROS: negative except above PMH: HTN NKDA Meds: HCTZ - no side effects Fx: Osteoarthritis in mother Patient eats healthy and exercises several times weekly.

periods were regular 28 day cycles vaginal dryness irregular periods, Periods have been irregular female hot flashes lasting between 2-6 days, alternating between heavy and light for 3 years night sweating 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44yo WF c/o irregular periods for the last 3 years. Periods last 2-6 days every 3w to 4 months and are light to heavy. Pt also reports hot flashes and sweeting 1-2x/months and vaginal dryness. Terminal insomnia since a few months not associated to any worries. No pattern. No spotting, no vag discharges, no itching. Nothing precipitates symptoms. G2P2 2 vaginal deliveries. ROS : No hair changes or skin changes. No bowel changes, no urinary complaints. No headaches. Last week had nausea and vomitting for 2 days but everything resolves spontaneously. PMH : HTN diagnosed 6 years ago PSH None Meds : HCTZ NKDA FH : Brother has HTN, Mother has obesity and osteoarthritis Office manager No EtOH, tabacco or rec drugs Sex active with husband only.

Sex active vaginal dryness irregular periods Last week had nausea and vomitting for 2 days WF hot flashes Periods last 2-6 days, every 3w to 4 months, are light to heavy for the last 3 years sweeting Terminal insomnia 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms Montgomery G2P2 44 yo f here c/o irregular periods for the past 3 years. Her periods are totally unpredictable for 3 years now. Can come in 3 weeks or in 4 months. Can last 2 days or 6 days. She also gets hot flashes in the last year, and woke up drenched in sweat recently. Previosly her menses were always regular, 5d/29d with 2/3 tampons/pads per day. Denies HA, vision/hearing changes, SOB, CP, abdominal pain, dizziness, weakness, numbness or tinglings. ROS negative except above ObGyn menarche 14 yo, regular 5d/29d with 2/3 pads per day, Pap smear last year normal, never abnormal Pap smear, no abortions or miscarriages, G2P2, no abnormal discharges PMH HTN 6 yrs Meds HCTZ Allerg NKA PSH none FH mom osteoarthritis, dad well SH denies tobacco, EtOH, drugs, and STIs, sexually active with husband only

Previosly her menses were always regular Pap smear last year sexually active irregular periods, periods are totally unpredictable f hot flashes Can come in 3 weeks or in 4 months, Can last 2 days or 6 days for the past 3 years, for 3 years now drenched in sweat 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 YO F IN CLINIC C/O IRREGULAR PERIODS, WAS INITIALLY EVERY 28D, LASTING 5D OF FLOW, NOW 2-6D, SOMETIMJES HEAVY OR LIGHT, A RANGE OF 5-6 PADS NOW FROM 2-3 PADS. LMP 2 MO AGO. MENARCHE WAS 14Y, A/W VAGINAL DRYNESS, G2P2, NO HX OF ABORTIONS OR MISCARRIAGES, PAP SMEAR DONE NORMAL 2MO AGO. A/W HOT FLASHES, SWEATING, VAGINAL DRYNESS. DENIES VAGINAL ITCHING, DISCVHARGE, BREAST TENDERNESS/FULLNESS, CHANGES IN VOICE/ WTR/ SKIN/ HAIR/ VISION, HA, MOOD, COLD INTOLERANCE, BM/URINARY HABITS, FEVER, CHILLS,,LAD,M ABD PAIN, HIRSIUTISM. SEX ACTIVE WITH HUSBAND, USES IUD X 20Y, CHANGES 4 YA. ROS NEG EXCEPT AS ABOVE PMH HTN X 6Y MED HCTZ NKDA PSH/HOSP/TRAVEL/TRAUMA NONE FH BROTHER HAS HTN, MUM OSTEOATHRITIS, DOESNT RECALL MUM MENOPAUSAL AGE SH LIVES WITH HUSBAND AND KIDS, ,INVESTMENT MANAGER. DRINKS ETOH RARELY, DENIES SMOKING, REC DRUGS, EXERCISE REG, HEALTHY DIET

INITIALLY EVERY 28D, INITIALLY LASTING 5D IUD SEX ACTIVE VAGINAL DRYNESS, VAGINAL DRYNESS IRREGULAR PERIODS F LMP 2 MO AGO HOT FLASHES NOW 2-6D, SOMETIMJES HEAVY OR LIGHT, RANGE OF 5-6 PADS NOW FROM 2-3 PADS SWEATING 44 YO

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo F with chief complaint of irregular periods. The patient states that three years ago her periods became very irregular. They are unpredicatable, there is no longer a regular cycle, the duration varies from 2-6 days. Sometimes the bleeding is very light, sometimes heavy requiring 5 or 6 pads a day. Prior to this she had regular periods every 28 days, lasting about 5 days, requring 2 or 3 pads a day. Menarche was 14. She is G2P2, both deliveries were vaginal. She is sexually active with only her husband, does not use condoms. Has a copper IUD, placed 4 years ago. She follows with an OBGYN and, she had a normal pap smear last year. Denies any urinary frequency, urgency, or dysuria. No changes in bowel habits. No history of STD. ROS: nause and vomitting last week for a few days Meds: HCTZ Allergy: NKA PMH: HTN PSH: none FH: mother-osteoarthritis, brother-HTN SH: rarely drinks, never smoker, no illicit drugs, sex with husband

Prior to this she had regular periods pap smear last year IUD sexually active, sex with husband irregular periods, They are unpredicatable nause and vomitting last week for a few days F periods became very irregular, Sometimes the bleeding is very light, sometimes heavy, duration varies from 2-6 days three years ago 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery is a 44 year old female with PMH of HTN who presents for 3 years of irregular periods. Pt reports that 1st period was at 14 yo and have been 28 day cycles, 5 days periods with moderate bleeding and mild cramping until 3 years ago when periods started to be irregular with 3 weeks up to 4 months between periods. Denies spotting between periods. Her flow is light and there are no cramps. She has hot flashes 2 amonth and vaginal dryness (treated with lubricant for intercourse). She is G2P2, with two living children both normal vaginal deliveries. No hx of STIs, monogamous with husband. No change in libido. Last pap nl (no hx of abnormal), last mammo normal. Denies weight changes, palpitations, diarrhea, dry skin, change in hair growth. ROS: negative except for above PMH: HTN Meds: copper IUD and HCTZ Surgeries:no social: no tobacco, social ETOH, no recreational drugs.works as office manager. Allergies: none

have been 28 day cycles IUD vaginal dryness irregular periods female hot flashes 3 weeks up to 4 months between periods for 3 years, until 3 years ago 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 y/o G2P2 no pmh here for chronic worsening amenorrhea for the last 3 years with episode of recently drenching the clothes. nl menarche age 14 with 28 day cycles and period lasting for 5 days. now unpredictable, lmp 2 months ago. Sexually active no protections. episode of nausea and vomiting last week that resided. No fever, cough, chest pain, change in bowel movement, urinary frequency, discharge or abd pain. No bruising or masses. No sick contatcs. ROS- as per hpi ph- none meds- HCTZ no allergies fh- noncontributory sh- nonsmoker, non alchohol, no drugs, unprotected sex with partner.

nl menarche age 14 with 28 day cycles and period lasting for 5 days Sexually active no protections 28 day cycles and period lasting for 5 days, now unpredictable G2P2 lmp 2 months ago here for episode of recently drenching the clothes 44 y/o

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo female c/o irregular menstruation x 3 years. She has associated breast tenderness, lower back pain, vaginal dryness. She reports mild associated dysnmenorrhea. There is no vaginal discharge, weight changes, cold insensitivity, headache. She has an IUD since 4 years ago. She reports no trouble falling asleep, but has had episodes where she wakes up at night. Menarche 14 years old, usually lasts 2-6 days, pad consumption varies with flow ROS: As per HPI, the rest are negative ALLERGIES: none MEDICATONS: HCTZ PMH: Hypertension x 6 years ago PSH: No previous surgeries FH: Older brother with hypertension Sexual Hx: Sexually active with husband SH: works as an office manager, denies smoking tobacco, rarely drinks alcohol on special occasions,

IUD Sexually active vaginal dryness irregular menstruation female lasts 2-6 days x 3 years wakes up 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Mrs. Montgomery is a 44 yo female presenting today with chief complain of irregular menstrual periords for the past 3 years. Her periods last 2-6 days and occur anywhere from 3 weeks to 4 months apart. Her last menstrual period was 2 months ago. She experiences 2 day day course of nausea and vomitting 1 week ago which resolved on its own. She denies weight change, fevers, but reports hot flashes Denies lumps in her throat. Denies vaginal discharge, dyspyruneia, dysuria. VS: WNL PMH: HTN Allergies: none Medications: HCTZ FamHx: Noncontributory. Obstetric: Last Papp smear three ayears ago. Normal. No h/o abnormal Papp. Last mammorgram one year ago; normal. Previously normal periods since menarche at age 14. Social: Married. Two sons. denies smoking and illicit drug use. Sexually active with spouse. Copper IUD for contraception. Inserted 4 years ago.

Previously normal periods IUD Sexually active irregular menstrual periords nausea and vomitting 1 week ago Mrs, female last menstrual period was 2 months ago hot flashes periods last 2-6 days, occur anywhere from 3 weeks to 4 months apart for 3 years 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: The patient is a 44 year old female who presents with irregular periods. Her last period was 2 months ago. Over the past 3 years her periods have been "unpredictable," with various amounts of bleeding and frequency of menstrual cycles. She also endorses vaginal dryness, discomfort with intercourse, hot flashes, and nausea and vomiting last week. She has an IUD x 4 years. She typically has mild cramps and breast tenderness with periods. Menarche was age 14, first pregnancy age 30, second pregnancy age 34. Both pregnancies uncomplicated. Patient denies HA, chest pain, SOA, abdominal pain. Denies dysuria, hematuria. Denies seeing blood in her stool. Denies unintentional wt loss, weight gain, dry skin. No breast discharge. PMH: HTN PSH: none Medication: HCTZ Allergies: none FH: unremarkable SH: no tobacco, ETOH rare, no drugs. Sexually active with husband only. Feels safe at home. IUD in place. ROS otherwise negative

IUD, IUD Sexually active vaginal dryness irregular periods, have been "unpredictable," female last period was 2 months ago hot flashes various amounts of bleeding, various frequency Over the past 3 years 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 y/o female presents with 3 year history of irregular periods. Periods have been irregular for 3 years and may occur 2-3 months and lasting 2-6 days. She has had cramping abdominal pain assoc with last menstrual cycle. Pt also compains of vaginal dryness and has been using lubricant that helps. PMHx: HTN dx 6 y/o using HCTZ and compliant; no side effects. GYN/Sexual Hx: G2P2; currently sexually active with husband, no barrier contraception Social Hx: lives with husband and 2 sons. Feels safe at home with good suppport system Pt denies ever smoking. alcohol rarely

sexually active vaginal dryness irregular periods, Periods have been irregular female lasting 2-6 days 3 year history of, for 3 years 44 y/o

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: HPI: Patient is a 44 years old female, complaining of irregular periods for the past 3 years, stating previously as regular, eveyr 28-29 days, lasting 5 days, regular flow (3-4 pads a day). Currently very irregular, with no specific pattern, ranging from 3 weeks to 4 months, light to heavy flow and last 2-6 days, Last mentrual perior 2 months ago. Patient also copmlains of Hot flashes en excessive sweating, with no change in mood or behaviour. ROS: negative except as explained above PMH: HTN diagnosed 6 years ago, treated with HCTZ, with daily compliance surgery hx: negative FH: father alive and in good health, Mother alive and overweight with osteoporosis, older brother alive with HTN SH: works as office manager, drinks 1 glass of whine very sporadically, no smoking, no illicit drugs, diet low on fat and salt, walks 3-4 week obgyn: g2p2a0, currently sexualy active with husband, birthcontrol with UID., last pap smear 1 yr,normal

previously as regular, previously eveyr 28-29 days, previously asting 5 days, previously regular flow last pap smear 1 yr UID sexualy active irregular periods, Currently irregular, Currently no specific pattern female Last mentrual perior 2 months ago Hot flashes ranging from 3 weeks to 4 months, ranging from light to heavy flow, ranging from last 2-6 days for the past 3 years excessive sweating 44 years old

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 y-o F c/o irregular perios over the last 3 years - previously regular periods, each 28 days, lasting 5 days, moderate flow, no clots - since the last 3 years, periods have been irregular, unpredictable, lasting 2 to 6 days, no cramps, no spotting between them - refers hot flashes and change in sleep pattern (sleeping less, awakes at 4 am and can not sleep again) - denies change in libido, tremor, or weight change GYN/OB: G2P2 at ages 30 and 34; vaginal deliveries; no OCP; menarche at age 14 Allergies: NKDA Medications: HCTZ PMH: hypertension FH: mother has ostheoarthritis; father is healthy SH: no smoking, EtOH socially, sexually active with husband only

previously regular periods, previously periods, each 28 days, previously periods lasting 5 days, previously periods moderate flow sexually active irregular perios, periods have been irregular, periods have been unpredictable F hot flashes lasting 2 to 6 days over the last 3 years, since the last 3 years change in sleep pattern, sleeping less, awakes at 4 am 44 y-o

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo F, irregular periods x3 years. There is no pattern, can be every 3 weeks to every 4 months. They typically last 2-6 days and can sometimes be heavy requiring 5-6 pads or light requiring 2-3 pads. There is no pain associated. LMP was 2 months ago and lasted for 4 days. Menarche was at age 14. Her periods were regular before 3 years ago. She reports a recent illness of nausea and vomiting last week for a few days for which she took some peptobismal and it resolved. She also woke up one night last week drenched in sweat. Denies any abdominal pain, diarrhea, constipation, hematochezia, dysuria, hematuria, incontinence, vaginal discharge or itching, fevers, chills, cold intolerance, or palpitations. Has cooper IUD. pmhx: HTN meds: HCTZ social hx: No tobacco, rare alcohol use, no drus. Sexually active with husband. No hx STIs. Walks 3-4 times a week for 30-45 minutes. Has 2 boys, 14 and 10 yo. No miscarriages or abortions.

IUD Sexually active irregular periods, periods no pattern recent illness of nausea and vomiting, nausea and vomiting last week, nausea and vomiting for a few days F LMP was 2 months ago every 3 weeks to every 4 months, last 2-6 days, can be heavy or light, can requiring 5-6 pads or requiring 2-3 pads x3 years 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 3 years of irregular periods. LMP 2 mo. ago. Frequency of menses ranges from 3 weeks to 4 months. Menarche at age 14 - until age 41, had regular menses every 28-29 days, lasting 4 days, and associated with breast tenderness, cramping and back pain. Associated menstrual symptoms have resolved over the past month. Has been having night sweats, hot flashes. Describes vaginal dryness with sexual intercourse. No weight loss or gain. No fevers. No skin/hair changes. No change in bowel movements, or mood. Normal pap smear, mammogram 1 yr ago. OBGYN Hx: 2 uncomplicated pregnancies. Normal pap and mammogran 1 y PMHx: Hypertension, well-controlled with no recent changes in meds. No prior STIs PSH: None Meds: HCTZ, daily. Full complicance. Allergies: none Fhx: maternal osteoporosis. paternal HTN SHx: sexually active with husband

until age 41 menses every 28-29 days, until age 41 menses lasting 4 days, until age 41, had regular menses, had regular menses pap 1 y, pap smear 1 yr ago, Normal pap 1 y sexually active, sexual intercourse vaginal dryness irregular periods menstrual symptoms have resolved, Associated menstrual symptoms have resolved over the past month LMP 2 mo. ago hot flashes, Has been having hot flashes Frequency of menses ranges from 3 weeks to 4 months 3 years of night sweats, Has been having sweats

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 y/o G2P2 F complains of irregular period over the past 3 years. Her periods were last regular 3 years ago. Her periods no occur anywhere from 3 weeks to 4 months, 2-6 days of bleeding, and her periods are heavy or light. She also notes hot flashes and sweating for the past year. She did note 1 night last week she awoke drenched in sweat. She complans of vaginal dryness, but denies vaginal discharge, HA, fatigue, or recent STDs. Her last pap smear was 1 year ago and normal. She denies any anormal pap smears in the past. She denies heat or cold intolerance, hair loss, change in her weight, or nipple discharge. She denies dysparunia, dysuria, or dysmenorrhea. ROS: no CP, N/V, SOB, abd pain, rashes, msk pain PMH: HTN for 6 years Medication: HCTZ FH: osteoarthritis in mother, HTN in brother SH: office manager, no tobacco use, occasional alcohol use, no illicit drug use

periods regular 3 years ago, Her periods were last regular 3 years ago pap smear was 1 year ago, Her last pap smear was 1 year ago vaginal dryness, She complans of vaginal dryness irregular period, complains of irregular period F, G2P2 F hot flashes, She also notes hot flashes periods occur from 3 weeks to 4 months, periods 2-6 days of bleeding, periods are heavy or light, Her periods no occur anywhere from 3 weeks to 4 months, 2-6 days of bleeding, and her periods are heavy or light, 2-6 days of bleeding, occur anywhere from 3 weeks to 4 months over the past 3 years, complains of irregular period over the past 3 years sweating, drenched in sweat, She also notes sweating 1 night awoke 44 y/o

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Dolores Montgomery 44 yo F presenting today due to irregular periods for the last 3 years. They were very regular before this time but have recently been irregular and random. Can be 3 weeks apart to 4 months apart. She also notes some hot flashes and sweating at random times over the last few years about 1-2 times per month. She notes vaginal dryness and discomofort on intercourse with husband as well during this time. She uses 3-4 pads per day usually, but sometimes experiences slightly heavier periods now as well. She notes one episode of PMS symptoms with breast tenderness, cramps, and low back pain that was mild before the last period. She denies vaginal discharge, no vision changes, no HA, no nipple d/c PMH: 2 vaginal deliveries, normal; last Pap 1 year ago, normal; Menarche at 14; hx of HTN 6 yrs, has IUD Meds: HCTZ Allergies: NKA FH: Non-contributory SH: Happy home, works in office, social drinker, never smoked, never drugs

were regular before Pap 1 year ago IUD on intercourse vaginal dryness irregular periods, recently been irregular, recently been random F hot flashes Can be 3 weeks apart to 4 months apart for the last 3 years, for 3 years sweating 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Montgomery os a 44 y.o G3P3 female with PMH of HTN who presents with 3 years of irregular periods. Prior to three years has had regular periods every 28 days with normal flow. she also complains of occasional hot flashes and sweating along with vaginal dryness. she denies any abdominal pain or changes in bowel or urinary habits. First had her period when 14. she has had two uncomplicated pregnancies. PMH: HTN Meds: HCTZ FH: Mother has OA, father with HTN SH: None Allergies: None SH: Never smoked, drinks ocassionally, no recreational drug use. sexually active with husband does not use barrier contraception. No history of prior STI.

Prior to three years has had regular periods, every 28 days with normal flow sexually active vaginal dryness irregular periods female hot flashes presents with 3 years of sweating 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo with PMH of HTN, presents w/ irregular periods. Reports that she used to have regular periods, but for the past three years has had periods that range from 2-6 days in length, and that can be light to heavy bleeding. She is not sure how many periods she has had in the past 12 months, but she has not had a period every month. Her LMP was 2 months ago. She has also been exerpiencing vaginal dryness and hotflashes several times a month. 1 week ago, she woke up in a drenching sweat, which is what prompted her to come to the doctor today. She used to have pre-menstrual cramps regularly but had not had them recently until her LMP. She has no family history of endometrial/ovarian or breast cancer. She is unsure when her mother went through menopause. She denies smoking and drinks infrequently. she denies abdominal pain or changes in urination. She denies recent weight loss.

used to have regular periods vaginal dryness irregular periods LMP was 2 months ago hotflashes periods that range from 2-6 days in length, can be light to heavy bleeding for the past three years drenching sweat 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44yo F presents with menstrual irregularities which began 3 years ago. She state they are getting unpredictable and she is getting worried. LMP was 2mo ago, menarche at 14, period last about 4 days and are irregular. denies vaginal discharge, cramping, spotting, and her last pap smear was normal last year. She is sexually active with husband, and has a copper IUD in place. no history of STIs. Denies abdominal pain, headache, edema, problems with urination or deffication. ROS: Neg except as per HPI PMH: HTN Meds: HCTZ SH: none FH: brother has HTN Social: Lives at home with 2 kids and husband. Sex with husband, drinks on occasion, no smoking or drugs.

last pap smear last year IUD sexually active, Sex with husband menstrual irregularities, period are irregular, they are getting unpredictable F LMP was 2mo ago began 3 years ago 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44yo F patients comes complaining of irregularity in her periods that has been going on for 3 years. Periods range between 2-6 days and they happen in a range every 3 weeks-4 months. She also complains of hot flashes, sweating, and vaginal dryness. Denies mood changes, no skin dryness and her cramps are less prominent. Also wakes up earlier than usual ROS: negative except as above/ PMH: high BP treated with ace inhibitors A:NKDA PSH: none FH:mother with osteoarthritis, brother high BP SH: lives with husband and kids. Office manager, drinks champane in special ocassions, No smoke no illicits. OBGYN: LMP: 2 months ago, P2G2 normal vaginal deliveries. Last PAP smear normal

vaginal dryness irregularity in her periods F LMP: 2 months ago hot flashes Periods range between 2-6 days, happen in a range every 3 weeks-4 months going on for 3 years sweating wakes up earlier than usual 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo F has C/O irregular periods. Her periods have been irregular for the last 3 years. She states that the periods last anywhere from 2-6 days, can be either heavy or light. and has no timeframe for when they appear. She says she has hot flashes 1-2 times a month and night sweats last week. She denies any blurry vision, fatigue, feelings of cold, chest pain, abdominal pain, changes in bowels and weight gain. Patient denies any feelings of sadness or depression. ROS: Negative except those stated in HPI PMH: HTN Allergies: None Medications: HZTZ Hospitalizations: Vaginal delievey. Fhx: Mother has osteoarthritis, brother has high blood pressure. OBGYN: Mechanice at age 14. Periods were regular till 3 years ago, used 2-3 pads. No vaginal discharge SH: no smoking, no etoh, no history of stds. Sexual active with husband, monogomous

Periods were regular Sexual active, monogomous irregular periods, periods have been irregular F hot flashes last from 2-6 days, can be heavy or light., has no timeframe for when they appear for 3 years, till 3 years ago night sweats 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yr old f w/ 3 yrs irregular menstrual bleeding -notes no pattern to her perioeds -notes it feeling crampy -nothing makes it better or worse -Notes hot flashes, sweating, nausea, vomit, early morning waking No previous episodes. No allergies. Takes HCTZ for hypertension. No trauma, or surgeries. ROS neg except for above. OBGYN: LMP 2 months ago, menarchy at age 14, period used to last 6 days but now unpredictable, uses 6 tampons a day, notes vaginal dryness, G2P2. Sex hx: active w/ husband, uses IUD, no hx of STDS. Soc hx: lives w/ family, she is a manager at a company, no unusual stress. Occasional wine, denies tobacco, and recreational drugs.

period used to last 6 days IUD Sex hx: active vaginal dryness irregular menstrual bleeding, no pattern to her perioeds, period now unpredictable f LMP 2 months ago hot flashes w/ 3 yrs sweating early morning waking 44 yr old

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Patient is a 44 year old G2P2 female with irregular menses for 3 years. Menarche age 14, regular menses 28 days for 5 days with moderate flow (3-4 pads a day) and premenstrual sx breast tenderness, lower back pain, mild menstrual cramps. Periods became unpredictible over last 3 years, duration 2-6 days ranging light (1-2 pads/day) to heavy (6 pads/day) with frequency ranging 3 weeks to 3 months. LMP 2 months ago for 4 days, moderate flow (prior was 3 weeks), accompanied with premenstrual sx (that ceased for 3 years prior). Random hot flashes, diaphoresis (1 episode night sweats), vaginal dryness over past year. Vaginal discomfort with intercourse, improved with lubrication. ONe week ago 2 days of stomach flu with nausea/vomiting, self-resolved in 2 days. PMH: HTN treated with CHTZ, no surgeries, 2 vaginal births, normal pap smears

regular menses for 5 days, regular menses with moderate flow, regular menses 3-4 pads a day with intercourse Vaginal discomfort improved with lubrication irregular menses, Periods became unpredictible ONe week ago flu, ONe week ago nausea/vomiting premenstrual sx ceased female LMP 2 months ago duration 2-6 days, ranging light to heavy, ranging 1-2 pads/day to 6 pads/day, frequency ranging 3 weeks to 3 months over last 3 years, for 3 years 44 year old

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo F with a h/o HTN who complains of irregular menses. started 3 years ago, no pattern to when menses occurs, periods may range from light to heavy (6 pads/ day), lasting from 2-6 days. Has hot flashes and night sweats not accompanied with menses. Menses was previously regular. No h/o surgeries, denies h/o fibroids, thyroid abnormalities. Reports 1 episode of breast tenerness, cramping, and back pain. Denies painful menses, fever chills, nausea, vomitting, consitpation, diarrhea. FH: brother - HTN, mom - osteoarthritis, obesity SH: lifetime nonsmoker, uses alcohol socially, denies IV drug use, denies any increased stress

Menses was previously regular irregular menses F hot flashes no pattern to when menses occurs, range from light to heavy, lasting from 2-6 days started 3 years ago night sweats 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms Montgomery is a 44yo female with chief complaint of irregular meses x 3 years. Her periods last from 2-6 days and alternate between light spotting and heavy bleeding requiring 5-6 pads per day. LMP was 2 months ago. Prior to 3y ago she had regular 28 days cycles. She is a G2P2 with normal vaginal deliveries 10y ago and 14y ago. She is utd on her pap smears, last was 1 year ago, nl. UTD on mammograms, last 1y ago nl. ROS: denies heat/cold intolerance, denies hirsutism, denies voice changes. No changes in bladder or bowel habits. PMH HTN, treated with HCTZ denies allergies No family history of irregular menses lives with husband and children, everyone feels safe No smoking or illicit drugs, drinks socially

had regular 28 days cycles pap smears, last was 1 year irregular meses female LMP was 2 months ago alternate between light spotting and heavy bleeding, last from 2-6 days x 3 years 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo female c/o irregular periods - started 3 years ago, is getting worse, has never had this before - irregular periods that las for 2-6 days and may have a light or a heavy flow, LMP was 2 months ago - has hot flashes - denies dysmenorrhea, weight changes, stool changes, fatigue, urine changes, vaginal discharge, hair changes, visual changes, skin changes, fever or mood changes. - PMH: HTN treated with HCTZ, had 2 vaginal deliveries (the last was 10 years ago); Allergies: none, PSH: none, FH: mother has osteoarthritis and brother has HTN - SH: no smoking, is a office manager, has a diet with low salt and fat, no drugs, drinks etoh on rare ocasions (1 glass of wine), exercises 3x a week, feels safe at home, is sexually active with husband only

sexually active irregular periods, irregular periods female LMP was 2 months ago hot flashes las for 2-6 days, may have a light or a heavy flow started 3 years ago 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Mrs Montgomery 44 year old F Presented wth Irregular Mesntruation. For Past 3 years has noted abnormal/irregular mestrual cycle length -time between cycles varying between 3 weeks and 4 months - and volume of menstrual blleding - sometimes very heavy cycles, sometimes very light. Periods last between 2 and 6 days. No spotting or abnormal vaginal discharge or itch. Has noted vaginal dryness and occasional hot flashes. 1x episode of night sweats last week. No weight change, fatigue, skin or hair changes or abdominal pain. Bowel and bladder habit normalObs/Gyn Hx: Previously periods were every 28-29 days and lasted 5 days with 2/3 pads or tampons used per day. 2 uncomplicated pregnancies with vaginal deliveries. No miscarriages or abortions. PMH: Htn PSH: Nil Meds HCTZ NKDA Family Hx: Mother osteoarthritis and htn Social: Office Manager, Alcohol on special occaions only. non smler, no illicit drug use, sexually active with husband only

Previously periods were every 28-29 days, Previously periods lasted 5 days, Previously periods with 2/3 pads or tampons used per day sexually active vaginal dryness Irregular Mesntruation, abnormal mestrual cycle, irregular mestrual cycle F, Mrs hot flashes time between cycles varying between 3 weeks and 4 months, sometimes heavy sometimes light, last between 2 and 6 days For Past 3 years, For 3 years night sweats 44 year old

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Montgomery is 44year old female with cheif coplaint of irregular periods. For the past three years she has had unpredictable periods both in time and heaviness. Prior to this periods were every 28-29 days with moderate flow and some pms. last period was 2 months ago and moderate flow. SHe endores one episode of drenching sweats last weak and occaisonal hot flashes. Also complains of stomach flu last week with n/v. She endorses vaginal dryness but no pruritis or discharge. OB/GYN history: 2 children via uncomplicated vaginal birth. Used IUD for contraception x20yrs, most recently changed 4 yrs ago. ROS: Denies HA, dizziness, weakness, tremors, CP, SOB, constipation, diarrhea, weight change PMH: HTN PSH: none meds: HCTZ allergies: NKDA Family: mother has OA, brother has HTN Social: works as office manager, lives with husband and 2 children. Safe in marriage, sex only with husband, uses lubricant. Rare EtOH, no tobacco

Prior to this periods were every 28-29 days IUD sex only with husband vaginal dryness irregular periods complains of stomach flu last week with n/v female last period was 2 months ago hot flashes unpredictable heaviness, unpredictable in time For the past three years drenching sweats 44year

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: Ms. Montgomery is a 44yoF who presents with 3 years of irregular periods. These periods can last for 2-6d with variable amounts of flow and are not associated with pain, crmaps, breast tenderness, or back pain which are her usual PMS symptoms. Her last period was 2 months ago which she did have pain but says it was a normal period for her. She had recent history of flu-like gastric distress last week. She denies any bleeding anywhere else but does admit to night sweats recently without fever. She has 2 children who were born vaginally with uncomplicated pregancies. She uses IUD for contraception which was placed 4 years ago. Pt had PAP last year and has no history of abnormal paps. She has HTN for which she takes HCTZ and NKDA. Mother has obesity and osteoarthritis, brother has HTN. She does not smoke, has EtOH rarely, no drugs, is married for 20years, and works as an office manager.

had PAP last year IUD irregular periods recent history of flu -like gastric distress, flu-like distress last week not associated with PMS symptoms, not associated with crmaps, breast tenderness, or back pain Ms, F last period was 2 months ago can last for 2-6d, with variable amounts of flow with 3 years of night sweats 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 y F c/o irregular periods. Menarche was 14 yrs. Cycles were 28-29 days. 3/4 pads a day. No spotting or bleeding in between cycles. Vagina is dry, uses lubricant. Having hot flashes and woke up one day with sweat. No STDS/hiv test. Has vomited couple of days ago, no blood. No abortions/miscarriages. No numbness or tingling. Denies vision changes, chest pain, SOB. Appetite is good. Excerises 3-4 a week. Works as an office manager. ROS-negative PMH- high BP A-none medications-HCTZ Sh-none Sexual- with husband, IUD, no std in past, no hiv test Social- drinks on rare occasions, does not smoke/use illicit drugs Fh-Brother high BP, mother- osteoarthritits Diet- low fat/salt

Cycles were 28-29 days IUD Sexual- with husband Vagina is dry irregular periods vomited couple of days ago F hot flashes woke up one day with sweat 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: CC: Irregular peroids HPI: 44 year olf F c/o irregular peroids for the last 3 years. Patient says she sometimes goes months without a menstrual period. Patient endorses night sweats with subjective fevers for the last year. Denies vaginal puritus, pain-ful sexual intercourese, discharge and intermenstrual bleeding. ROS: Per hpi OB/GYN: G2P0: both vaginal. LMP; 2 months ago. Peroid frequncy ranges from weeks to months and last 2-6 days. Last pap smear was 1 year ago; it was normal. No history of abnormal pap smears. No history of STDs. PMH: Hypertension PSH: None Meds: Hydrochlorothiazide Allergies: None SH: Works in office management. Lives with husband and two kids. Sexually monogamous with husband. Denies tobacco and recreational drug use. Occasional alcohol; a few drinks a month

Last pap smear was 1 year ago Sexually monogamous Irregular peroids, irregular peroids F LMP; 2 months ago for the last 3 years night sweats 44 year olf

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44yo woman c/o 3yrs of "unpredictable" periods last 2-6d, with flow light to heavy, q3wks to 4mo. No spotting between periods. Endorses hot flashes and sweating and vaginal dryness- lubricant with husband during intercourse. Some abdominal pain with last menses but not usually. Last week, one episode of drenching night sweats with nausea and flu-like sx's, went away. Before, pt had regular periods ~q28d, lasting 4days with moderate flow and PMS symptoms- breast tenderness, back pain, cramps. Today, denies wt changes, voice changes, nipple d/c, vision changes, cold/heat intolerance, facial hair. Pt has 2kids, born vaginally, pregnancies uncomplicated- last born 10yrs ago. Has copper IUD- 4yrs old ROS: neg cough, cold-like sx's, chest palpitations/pain, SOB, vomiting, changes in bowel habits, dysuria, blood in stool/urine. PMH: HTN Meds: HCTZ Aller: none FH: noncontributory SH: manager, rare Etoh, no tobacco/drugs

Before had regular periods, Before periods ~q28d, Before periods lasting 4days, Before periods with moderate flow IUD during intercourse vaginal dryness- unpredictable" periods Last week, nausea, "Last week flu-like sxs" woman hot flashes last 2-6d, flow light to heavy, q3wks to 4mo 3yrs of sweating, night sweats, drenching sweats 44yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo G2P2A0 female presents to the clinic with irregular menstrual period for three years. The patient states that her menstrual period is unpredictable. The interval ranges from 3 weeks to 4 months. The duration ranges from 2-6 days. The flow ranges from very light amount to 5-6pads when heavy. She denies any spotting between menstruation, or cramps. The pateient denies vaginal discharge. Before that, patient had regular period of 28days and her menstruation lasted for 5 days with daily use of 2-3pads. She is sexually active with her husband and they use copper IUD for contraception. Patient noticed night sweat a week ago. Her last pap smear was normal a year ago. The patient denies headache, dizziness, skin change or change in hair. Patient denies intolerance to heat and cold. ROS: negative except the above. PMH: high blood pressure, MEDS: HCT FH: noncontributory SH: drinks alcohol 1-2glass/ month, tobacco(-), illicit drug (-)

Before had regular period, Before had period of 28days and her menstruation lasted for 5 days with daily use of 2-3pads pap smear a year ago IUD sexually active irregular menstrual period, period is unpredictable female interval ranges from 3 weeks to 4 months, duration ranges from 2-6 days, flow ranges from light to 5-6pads, flow ranges from light to heavy for three years night sweat 44 yo

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: HPI: 44 year old female presenting with irregular periods. Periods have been "unpredictable" for the last three years, occurring every 3-6 months w/ bleeding lasting 2-6 days and varying in amount from heavy to light flow. She also complains of vaginal dryness for the last year alleviated by lubrication. She woke up from sleep last week "drenched in sweat". She describes having "hot flashes" for the last two years lasting approx 1-2 minutes. Denies change in weight, change in bowel habits, fatigue, hirsutism, hair loss and mood change. LMP 2 months ago, had two negative home pregnancy tests last week. ROS: per HPI Allergies: NKDA Meds: HCTZ, IUD (x4yrs) PMH: Hypertension FHx: No thyroid disease or premature ovarian failure Obstetric: G2P2, uncomplicated pregnancies (children 10 and 14yrs) Social: No cigarette or illicit drug use. <1 drink EtOH/month. Sexually active w/ husband, uses protection. No Hx of STD

Sexually active vaginal dryness irregular periods, Periods have been "unpredictable female LMP 2 months ago hot flashes occurring every 3-6 months, lasting 2-6 days, from heavy to light flow for the last three years drenched in sweat woke up 44 year old

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo african american lady with irregular periods of 3 years, lasting each between 2 to 6 days with light to heavy flow as described, with no pelvic main or nausea or weight loss. she has intermittent hot flashes, sweating and vaginal dryness but no dyspareunia or vaginal infections , no dysuria or urinary frequency, no constipation, no bleeding disorder, no fatigue. menarche at 14 years.married with 2 kids, sexually active with her husband, has an IUD placed 4 years ago, no past surgeries. she has HTN on hctz.no allergies. nonsmoker nonalcoholic, walks daily, well balanced diet, no eleict drug use, 1 ocffee cup daily, happy with her husband, works as an office manager with no increasing stress levels. LMP was 2 months ago.last pap smear and mammography were normal last year.fam hx: mom has osteoarthritis and obese, brother has htn, no cancers in family

IUD sexually active vaginal dryness irregular periods lady LMP was 2 months hot flashes lasting each between 2 to 6 days, with light to heavy flow of 3 years sweating 44

You are a resourceful medical assistant. What are the keywords and phrases from the given patient note that can help make medical diagnosis?

Patient Note: 44 yo F G2P2 with 3 year history of irregular periods - regular periods before (5 days of periods with 20-29 days in between); used about 3-4 pads - now "unpredictable": 1 or more elements (bleeding, duration) change with each period, light to heavy bleeding, 2-6 days of period) - biggest concern: nocturnal heavy sweating - endorses: daytime hot flashes and sweating, nausea & vomitting x 2 days - denies: mood changes, weight changes, diet changes, new excercize regimen, no family history of early menopause Ob/Gyn: G2P2002, no gynecological issues, most recent pap smear 1 yr ago was normal, pregnancies and deliveries normal PMH: HTN PSHx: none Med/Allergies: HCTZ, no allergies FHx: no gynecological issues Soc: lives with hsuband and two sons, uses copper IUD; no past or present tobacco or recreational drug use; "rare" use of alcohol (champagne, weine) ROS: none except as stated above

regular periods before most recent pap smear 1 yr ago IUD irregular periods, now "unpredictable" F hot flashes 1 or more elements (bleeding, duration) change with each period, 2-6 days of period, light to heavy bleeding 3 year history of sweating, sweating 44