841 HEATHER ROAD BURLINGTON, NC 27215 336.229.7776 FAX 336.227.4242 www.ur ! "#NC.

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NAME: CHART #: DATE OF BIRTH: DATE: _____, _____ _____ 09/14/1934 11/__/2012

HISTORY OF PRESENT ILLNESS: Mr. Westbrooks is a 68-year-old white male with a history o kid!ey sto!es a!d diabetes. "e also has de#elo$ed ere%tile dys &!%tio! a!d wo&ld like some hel$ with that. 'e(&al health i!#e!tory or me! was 10. "e de!ied la!k $ai! or hemat&ria. "e is #oidi!) with a )ood stream. *+'' s%ore was 4. "e was last see! here o! ,o#ember 29, 2011. PAST MEDICAL HISTORY: Allergies: +atie!t had !o dr&) aller)ies. Current Medic ti!ns: "e does !ot take a!y medi%atio!s. Pre"i!us Surgic l Pr!cedures: *!)&i!al her!iorrha$hy. S!ci l Hist!r#: +atie!t de!ied toba%%o &se. "e %o!s&mes 8-14 al%oholi% be#era)es $er week. F $il# Hist!r#: -emarkable or hy$erte!sio!. ../!der this, &!less s$e%i ied $ositi#e or a %o!ditio!, $lease &se this !ormal00 P st nd Current Medic l C!nditi!ns: 1he $atie!t de!ies history o the ollowi!)2 a%id re l&(, aller)i% rhi!itis, a!(iety, arthritis, asthma, atte!tio! $roblems, bleedi!) disorders, breast %a!%er, ra%t&red bo!es, %olo! or re%tal %a!%er, de$ressio!, diabetes, eati!) disorder, ere%tile dys &!%tio! %c&ec' (!r gender !( ) tient*, )astroi!testi!al disease, heari!) $roblems, heart disease, hy$erte!sio!, hi)h %holesterol, i!som!ia, 3oi!t i!3&ries, kid!ey disease, li#er disease, l&!) %a!%er, l&!) disease, mi)rai!e heada%hes, obesity, osteo$orosis, o#era%ti#e bladder, +arki!so! disease, $rostate %a!%er %c&ec' (!r gender !( ) tient*, sei4&re disorder, e$ile$sy, se(&ally tra!smitted diseases, ski! $roblems, stroke, thyroid disease, a!d #isio! $roblems. Re"ie+ !( S#ste$s: 1he $atie!t de!ied the ollowi!) ..&!less s$e%i ied otherwise002 wei)ht %ha!)e, ati)&e, e#er, %hills, !i)ht sweats, rash, slee$ dist&rba!%e, do&ble #isio!, eye $ai!, loss o #isio!, di i%&lty swallowi!), %hest $ai!, swelli!) o le)s or a!kles, le) $ai!, short!ess o breath, %o&)h, %o&)hi!) &$ blood, !a&sea, #omiti!), diarrhea, %o!sti$atio!, heari!) loss,

<= . 9ladder a!d kid!eys were !ot $al$able.o ob#io&s a!(iety. +=--<.o $al$able re%tal masses. . <&!)s were %lear to a&s%&ltatio! with !ormal res$iratory e ort witho&t i!tra%ostal retra%tio!s.o $eri$heral edema. Rect l: +rostate 16 )m smooth a!d !o!te!der $rostate. A=M. blood i! &ri!e. easy br&isi!). $la%e a!d $erso!. ht 6768. di44i!ess.ENERAL: HEENT: Nec': L#$)& tic: Pul$!n r#: C rdi!" scul r: . +=--<. thyroid )la!d was smooth witho&t $al$able !od&les.I: . i!)&i!al or emoral her!ias. hair loss. tem$ 98. C rdi!" scul r: --. . $ai! &l &ri!atio!s. . =>Ms i!ta%t.o a&dible la!k br&its.o $al$able !e%k or )roi! ade!o$athy. re5&e!t alli!). .AM: -it l Signs: Wt 196 lbs.o a&dible la!k br&its. 9+ 148/:8. te!der!ess. . .o abdomi!al. '%lerae were %lear. . =>Ms i!ta%t.ener l: HEENT: Nec': Well-!o&rished male i! !o a%&te distress. Neur!/Ps#c&i tric: . . re5&e!t !osebleeds.6. 'tool s$e%ime! was !ot %olle%ted or i!di%ated. 9ladder a!d kid!eys were !ot $al$able.I: Well-!o&rished emale i! !o a%&te distress.o $al$able masses or te!der!ess. ht 6748. 9+ 140/84. .bdome! was so t with !o ?@. -emai!i!) $ortio! o $hysi%al e(am will be di%tated o! hos$ital system. L#$)& tic: . thyroid )la!d was smooth witho&t $al$able !od&les. <i#er a!d s$lee! were !ot $al$able or te!der.. blood i! stool. .stoma%h $ai!. --.bdome! was so t with !o ?@. .o $eri$heral edema. 'emi!al #esi%les !ot $al$able or swolle!. te!der!ess. i!)&i!al or emoral her!ias. PHYSICAL E. .AM: -it l Signs: Wt 160 lbs. de$ressio! or a)itatio!. . M. <i#er a!d s$lee! were !ot $al$able or te!der.<= . Pul$!n r#: <&!)s were %lear to a&s%&ltatio! with !ormal res$iratory e ort witho&t i!tra%ostal retra%tio!s. PHYSICAL E..lert a!d orie!ted to time. !&mb!ess i! arms a!d le)s. &!wa!ted )rowth o hair.o $al$able !e%k or )roi! ade!o$athy. 'tool s$e%ime! was !ot %olle%ted or i!di%ated.with a&dible m&rm&r or )allo$s.o abdomi!al. '%lerae were %lear.with a&dible m&rm&r or )allo$s. . $&lse 80.o $al$able masses or te!der!ess. swolle! )la!ds. !o a&dible %arotid br&its. re5&e!t &ri!ary i! e%tio!s. !o a&dible %arotid br&its.

6. mi%ros%o$i% D/9 re#ealed a 6 mm sto!e a!d a 2 mm sto!e i! the re)io! o lower $ole.o %ysto%ele or #a)i!al $rola$se.e)ati#e Marshall test.meri%a! male i! !o distress.?' M-W/abdB_____ . <e t !e$hrolithiasis.lert a!d orie!ted to time. 2 >btai! testostero!e a!d +'. te!der!ess. . alb&mi! 0. PLAN: 1.ormal e(ter!al emale )e!italia.o abdomi!al. 3.. smooth. . today. !o!te!der $rostate. Rect l: . i!)&i!al or emoral her!ias. -e$eat D/9 i! o!e year. Rect l: LABORATORY DATA: /ri!alysis C yellow.bdome! was so t with !o ?@.o &rethral hy$ermobility. $la%e a!d $erso!.o #a)i!al dis%har)e. "e had de)e!erati#e %ha!)es o the l&mbar s$i!e. *!str&%ted to %all or res&lts !e(t week. =re%tile dys &!%tio!. otherwise !ormal e(am. . A.o $al$able re%tal masses. 30-)m. s&)ar 0. $" 6. Eiabetes. ?er#i( a!d &ter&s were smooth a!d !o!te!der witho&t $al$able ad!e(al masses. __________________________ Mi%hael -. 2. %lear. Wol . IMPRESSION: 1.0: . 'tool s$e%ime! was !ot %olle%ted or i!di%ated. C yellow. M. . mi%ros%o$i% !e)ati#e. alb&mi! tra%e. . LABORATORY DATA: !e)ati#e..I: Well-!o&rished . <i#er a!d s$lee! were !ot $al$able or te!der. Neur!/Ps#c&i tric: .E. ri%a!-.o ob#io&s a!(iety.ener lB . . %lear. . . 9ladder a!d kid!eys were !ot $al$able. s&)ar 0. /. $" 6.