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提示词_3_9_47

Role and Objective

You are a highly experienced medical expert specializing in diagnosing and treating a wide range of diseases. Your task is to generate precise and standardized outpatient medical records based on face-to-face diagnostic conversations with patients. Use professional medical terminology and ensure compliance with U.S. clinical outpatient medical record standards.


Goals

  1. Analyze and summarize the medical record from the diagnostic conversation.
  2. Organize the record according to U.S. outpatient standards, ensuring accuracy and professionalism.
  3. Include key sections: Basic Information, Chief Complaint, History of Present Illness, Past Medical History, Personal and Family History, Physical Examination, Auxiliary Tests, Diagnosis and Assessment, and Treatment Plan.

Constraints

  • Act as a professional clinical outpatient expert.
  • Use precise and professional medical terminology.
  • Ensure all provided information is accurate and does not mislead the patient.

Skills Required

  1. Deep understanding of human diseases and medical knowledge.
  2. Ability to articulate complex medical concepts clearly in standard medical record formats.
  3. Proficiency in interpreting diagnostic results and clinical information to create concise yet comprehensive records.

Workflow

  1. Assess the patient’s health condition through dialogue.
  2. Interactively analyze and confirm the patient’s symptoms and medical history.
  3. Record the medical history, examination findings, and comprehensive clinical situation.
  4. Review, refine, and finalize the diagnosis and treatment plan in a standardized format.

notes

  • English in your output

病历_3_9_47

Outpatient Medical Record

Basic Information

  • Patient: Mr. Mingyang Huai
  • Age: 33
  • Gender: Male
  • Visit Purpose: Follow-up

Chief Complaint

  • Persistently elevated triglycerides from previous test.
  • Chronic urticaria lasting for several months.

History of Present Illness

  • Mr. Huai reported a triglyceride level increase to 500 mg/dL from a previous level of 195 mg/dL upon re-testing, raising concerns about potential factors influencing this spike.
  • Complains of chronic urticaria that has persisted for several months, with symptoms flaring up most acutely when in the domicile.

Past Medical History

  • No significant past medical conditions were reported.
  • No history of diabetes or other metabolic disorders.

Personal and Family History

  • Denies history of allergies apart from the present condition.

Physical Examination

  • Vital signs were within normal limits.
  • No other physical abnormalities noted during the visit.

Auxiliary Tests

  • Laboratory reports show elevated triglycerides at 500 mg/dL but normal blood glucose levels. No renal or liver function abnormalities were noted.
  • Hemoglobin A1c levels were also within normal range, ruling out diabetes.
  • Antihistamine skin eradication test: Positive for common allergens, including dust mites. Negative for pet dander.

Diagnosis and Assessment

  1. Hypertriglyceridemia, etiology to be further investigated, potentially related to non-fasting state during the last laboratory test.
  2. Chronic urticaria, likely driven by domestic allergen exposure.

Treatment Plan

  1. Rechecking triglyceride levels in a fasting state in January to confirm if hypertriglyceridemia is persisting.
  2. If elevated triglycerides persist, initiating lipid-lowering pharmacotherapy will be considered.
  3. Providing a prescription for an antihistamine for chronic urticaria relief - switched to Fexofenadine from previous medication for improved response.
  4. Recommendation to assess the home for dust mite presence and consider anti-dust mite bedding covers and regular laundering with heat drying.
  5. Advising the patient to obtain a flu vaccine for the upcoming flu season. The vaccine was administered during the visit.
  6. Advising a diet focusing on high-quality proteins and reduced red meat intake as part of lipid management.

Prescription Provided:

  • Antihistamine prescription (Fexofenadine).

Patient Education and Follow-up

  • Importance of a fasting blood test for accurate lipid panel results.
  • Should return for follow-up testing in January with fasting blood work.
  • Advised to obtain dust mite covers for bedding and to continue current dietary adjustments. Return to clinic for additional evaluation if symptoms persist or worsen.