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病历_3_7_45

Sure, below is the patient's outpatient record based on the diagnostic conversation:

Outpatient Medical Record

Basic Information

  • Patient Name: Liang Wang
  • Gender: Male
  • Age: 40
  • Date of Visit: [Insert Date]

Chief Complaint

  • Annual physical examination.

History of Present Illness

  • Patient reports past COVID-19 infection, with symptoms resolving rapidly after medication. Expresses interest in receiving current flu and COVID-19 booster vaccines.
  • Presents concern due to recent increase in heartburn episodes, approximately every one to two weeks. Symptoms not directly correlated with food intake and usually resolve without medication.
  • Recent history of constipation, noted to have become more frequent after a previous episode of rectal bleeding diagnosed as hemorrhoids.

Past Medical History

  • History of H. Pylori infection, previously treated.
  • Elevated blood glucose levels, monitoring with no significant changes.
  • Diet includes adequate fluid intake.
  • Discusses history of cutaneous lipomas without significant change in size or tenderness.

Personal and Family History

  • Family history of gastric issues in mother, including gastritis and esophageal thickening as precursors to potential malignancy.

Physical Examination

  • Vital signs: WNL (within normal limits)
  • Focused examination of the abdomen and cutaneous tissues for lipomas: WNL
  • Cardiovascular and respiratory examination: WNL

Auxiliary Tests

  • Ordered standard blood tests, including CBC, lipid profile, liver, and renal function tests.
  • Urea Breath Test for H. Pylori redisposition.

Diagnosis and Assessment

  • Reflux esophagitis may be contributing to heartburn episodes.
  • Constipation with no alarming features thus far; monitoring trends.
  • Elevated blood glucose levels, aligned with previous records.

Treatment Plan

  • Medications: Recommend trial of Omeprazole for symptomatic relief of heartburn.
  • Vaccinations: Administered influenza and COVID-19 booster vaccines.
  • Investigations: Schedule further GI assessments dependent on breath test results and persistence of constipation symptoms.
  • Follow-Up: Review of test results and symptomatology in one week; arrange specialist referral if necessary.

Please note: this medical record should be appended to the patient's existing records and thoroughly reviewed during subsequent visits.