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, History of Present Illness
Reason for Encounter
"I feel awful, I'm exhausted. I have a cough and body aches"
Sore throat and headache
History of Present Illness
Review of Symptoms
General: excellent, other than a little asthma that rarely bothers me
HEENT/NECK: Negative
Cardiovascular: Negative Nothing like that, my chest does not hurt at all
Respiratory: Negative breathe okay, just feel horrible
Gastrointestinal Negative
Genitourinary Negative
Musculoskeletal/Osteopathic Structural Examination: Body aches, no mobility issues
Neurologic: Negative
lntegumentary/Breast:
Psychiatric: I feel sick
Endocrine:
Hematologic/Lymphatic:
Allergic/Immunologic:
Past Medical History
PMH
Childhood asthma: no recent exaerbations. May be outgrowing
NO CHANGES
Hospitalizations/Surgeries: None
NONE
Preventative Health:
Up-to-date. Declined flu, said they offer it free at college, no COVID booster
NO FLU SHOT
NO COVID BOOSTER
Medications: Ibuprofen prn for occasional headache or athletic pain
Used to have an inhaler, stopped carrying it
OTC ibuprofen
Allergies: NKDA
Social History
No second hand smoke
No travel
Roommate was sick last week with a bad cough
Tobacco: denies Denies
Alcohol: denies Occasional beer or glass of wine
Drugs: denies Denies
Living Situatioin/Housing: Lives with roommate on campus
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