REVIEW OF SYSTEMS:  CONSTITUTIONAL: No fever. No chills. HEENT: No new headache, hearing or visual problems. He is hard of hearing. RESPIRATORY: No hemoptysis. No pleuritic chest discomfort. CARDIAC: No orthopnea or PND. No palpitations. GI: No reflux symptoms or blood in the stool. GU: No hematuria. SKIN: No new rashes. MUSCULOSKELETAL: No seizure abnormalities. NEUROLOGIC: As above. HEMATOLOGICAL/LYMPHATIC: No history of easy bleeding or bruising.

REVIEW OF SYSTEMS:  The patient’s weight has been stable over the past year. Cardiovascular: He has had angina in the past but is stable at this time. Pulmonary: He has had shortness of breath but no history of pneumonia. GI symptoms: He does have a history of constipation at times. Urinary symptoms: He has frequent urination with urgency requiring medical management. He has a history of carcinoma of the prostate. He has microscopic hematuria. Musculoskeletal: He has arthritic complaints and back pain. Neurological: No specific complaints.

REVIEW OF SYSTEMS:  GENERAL: Feels weak, fatigued. Appetite currently fair. No fevers, chills or night sweats. CARDIOVASCULAR: Denied chest pain, palpitations, orthopnea, or lower extremity edema. RESPIRATORY: Denied shortness of breath, cough, wheezing, sputum, sore throat. URINARY: Has had some episodes of urinary incontinence, but denies frequency, nocturia, dysuria, or hematuria. NEUROLOGIC: Numbness and tingling stocking/glove distribution lower and upper extremities. Has generalized weakness. ORTHOPEDIC: Uses a walker. No joint swelling. SKIN: No rashes or eruptions.

REVIEW OF SYSTEMS:  The patient denies any fever, chills, or night sweats. She denies any recent loss of consciousness or trauma. No headaches, lightheadedness, or dizziness. No nausea, vomiting, diarrhea, or constipation. The patient does describe chest pain, but no palpitations, paroxysmal nocturnal dyspnea, or orthopnea. She does describe shortness of breath and dyspnea on exertion. She does describe a dry, nonproductive cough. No hemoptysis, hematemesis, hematuria, or bright red blood per rectum. She denies any abdominal pain, but does describe increased abdominal girth. She does describe significant edema of her lower extremities. No urinary complaints. She states she has moved her bowels on a fairly regular basis. She describes decreased appetite and decreased oral intake. She has been on Ensure for the past week. She describes increase in weight gain. The remainder of her review of systems is as noted in the history of present illness.

REVIEW OF SYSTEMS:  The patient admits to fatigue; it has been a longstanding issue. She snores at night and does not awaken refreshed. She has a dog at home but denies any bug bites. She has had no rash, nausea, vomiting, fever, chills, diarrhea, constipation, melena, blood in her stool, headache, tooth pain, sputum production, chest pain or difficulty breathing. She feels safe at home. Her mood has been generally well controlled. She does exercise. She menstruates generally on a monthly basis, every other month being relatively heavy. She does not actively sunbathe. She does not sleep very well. She does get dental care.

REVIEW OF SYSTEMS:  The patient states that she has had some headaches, but they have not been severe. Her vision has been blurred somewhat and is not been helped by glasses. She reports no difficulty in swallowing, but her stomach does tend to bloat easily. She has had chest pains in the past and is troubled frequently by shortness of breath on exertion and also at rest. She does not cough frequently, but as mentioned above, she does often in the morning expectorate a small amount of blood. She has not been troubled by routine abdominal pains but has had episodes of diarrhea in the past. She reports no difficulty with urination and has not seen any blood in the stool. She does get some stiffness in her joints and swelling in the feet but no skin rashes, and her weight has been stable.

REVIEW OF SYSTEMS:
CONSTITUTIONAL: The patient denies fever, chills, night sweats, tiredness, fatigue, malaise, anorexia, or weight loss.
CARDIOVASCULAR: No lower extremity edema. She has been ambulating extensively. She denies chest pain, palpitations or orthopnea.
RESPIRATORY: Denies shortness of breath, cough, wheezing, or sputum.
GENITOURINARY: Denies frequency, nocturia, dysuria, or hematuria.
GYNECOLOGIC: No abnormal bleeding.
HEMATOLOGIC: No abnormal prolonged bleeding or bruising.
MUSCULOSKELETAL: No joint swelling, stiffness, pain or myalgias.
INTEGUMENTARY: She has eczema on her hands.
NEUROLOGIC: Negative for any focal neurologic complaints.
PSYCHIATRIC: Frequent awakenings. Denies anxiety, panic or depression.

REVIEW OF SYSTEMS:  On review of systems, the patient denies recent URI, fever, chills, weight loss or night sweats. No headache, visual symptoms, stiff neck. She had no associated neck, arm, jaw pain or pressure today. She does have chronic back and body aches, which are diffuse and varying in site from day to day. She denies significant abdominal pain, change in bowel habits, black tarry stools, bright red blood per rectum. No urinary symptoms. No swelling of her hand, feet or face. No neurologic symptoms. No rash. No lymphadenopathy. A 14-point review of systems is otherwise negative. The patient is completely asymptomatic at this time.

REVIEW OF SYSTEMS:  No history of heart or valve problems previously. No orthopnea or PND. Denies headache, dizziness or feeling faint. No visual disturbances, ear, nose of throat complaints, neck pain, stiffness, cough, sputum production, diabetes, hypertension, dyslipidemia, abdominal pain, nausea, vomiting, diarrhea, rashes, vesicular eruptions, lesions, numbness, tingling or paralysis.

REVIEW OF SYSTEMS:  The patient denies weight change, fatigue, weakness, fever, chills, night sweats. The patient denies itching, rashes, sores and bruises. The patient denies headache, nausea, vomiting, visual changes. Eyes, ears, nose, sinuses, mouth, throat, neck: No complaints. The patient denies shortness of breath, wheeze, cough, and hemoptysis. The patient denies chest pain and palpitation. The patient has normal appetite. Denies nausea, vomiting, dysphagia, abdominal pain, constipation, or diarrhea. The patient has normal urination. The patient has amenorrhea. The patient denies muscle weakness. The patient denies pain or joint stiffness. The patient denies restriction of range of motion. The patient has full range of motion of the upper and lower extremities.

REVIEW OF SYSTEMS:  No chest pain, palpitations, shortness of breath, nausea, vomiting, abdominal pain, lightheadedness, dizziness, sudden changes in vision, speech, gait, swallowing, memory, numbness, tingling, weakness, orthopnea, PND, lower extremity edema, myalgias, arthralgias.

REVIEW OF SYSTEMS:  He has had no frank gross hematemesis, no hematochezia, no melena or black tarry stools. No dizziness, feeling faint, visual disturbances, ear, nose or throat complaint, cough, shortness of breath, sputum production, chest pain, periumbilical pain, right lower quadrant pain, right upper quadrant pain, postprandial discomfort, rashes, skin breakdown, numbness, tingling or paralysis.

ROS Examples

REVIEW OF SYSTEMS:  The patient denies weight change, fatigue, weakness, fever, chills, night sweats. The patient denies itching, rashes, sores and bruises. The patient denies headache, nausea, vomiting, visual changes. Eyes, ears, nose, sinuses, mouth, throat, neck, no complaints. The patient denies shortness of breath, wheeze, cough, and hemoptysis. The patient denies chest pain and palpitation. The patient has normal appetite. Denies nausea, vomiting, dysphagia, abdominal pain, constipation or diarrhea. The patient complains of frequent urination. No blood in urine. No urine retention. No pain during urination. The patient usually goes to the bathroom during the night two to three times, during the daytime three to four times. The patient denies muscle weakness. The patient denies pain, joint stiffness. The patient complains of low back pain radiating to the left lower extremity with numbness of the left lower extremity and episodes of weakness of the left lower extremity. The patient has restriction of range of motion at the lumbosacral spine on flexion and extension. The patient has full range of motion of the upper and lower extremities.

REVIEW OF SYSTEMS:
CONSTITUTIONAL: There is no history of fever, weight loss or cough.
CENTRAL NERVOUS SYSTEM: No history of vision changes, seizure or weakness.
ENT: No history of congestion, postnasal drip, sore throat or hearing changes.
RESPIRATORY: No history of shortness of breath, wheezing or chest pain.
CARDIOVASCULAR: No history of chest palpitations or arrhythmias.
GASTROINTESTINAL: No history of nausea, vomiting, diarrhea or abdominal pain.
GENITOURINARY: No history of dysuria, frequency or vaginal discharge.
MUSCULOSKELETAL: Positive for ankle pain, joint pain, joint edema as well as right lower extremity edema with some tenderness in the calf area. The patient indicates that her pain is approximately 7/10.

REVIEW OF SYSTEMS:  The patient denies fevers, chills, sweats, headaches, dizziness, feeling faint, tinnitus, vertigo, hearing loss, nasal discharge, sore throat, trouble swallowing, neck pain or stiffness. No tunnel vision, blurred vision, loss of vision, amaurosis, seizure activity, neck pain or stiffness. No cough, shortness of breath, chest pain on exertion, asthma, hemoptysis. No history of pulmonary embolisms or pulmonary conditions. She denies retrosternal chest pain, radiating pain, abdominal pain, tooth pain, arm pain, chest pain exertion, CHF, cardiomyopathy, diabetes, hypertension or dyslipidemia. No generalized abdominal pain. No nausea, vomiting, diarrhea, heartburn, reflux, gallstones, kidney stones, hematuria, dysuria, urgency, frequency, hematuria, rectal discharge or bleeding. No rashes, skin breakdown, numbness, tingling with paralysis or shingles.

ROS Examples 1

REVIEW OF SYSTEMS:
CONSTITUTIONAL: She denies any recent weight changes, fevers or night sweats.
DERMATOLOGIC: She denies any rashes.
HEENT: Eyes: She has had no changes in her vision. No eye pain. No discharge. ENT: She had no hearing changes, no throat pain, no sinus difficulties. No hoarseness.
CARDIOVASCULAR: She denies any chest pain or abnormal heart beats, or any swelling in her ankles or feet.
RESPIRATORY: No wheezing or coughing.
GASTROINTESTINAL: As noted above in history of present illness.
GENITOURINARY: She denies any urinary urgency, frequency or burning, and there has been no blood in her urine. She has no flank pain. She has also had no vaginal discharge or bleeding.
MUSCULOSKELETAL: She notes full range of motion of all her joints without pain or swelling.
ENDOCRINE: She denies any heat or cold intolerance or excessive thirst or urination.
NEUROLOGICAL: Currently, no headache. She has no vision changes, dizziness or fainting. No numbness or tingling.
PSYCHIATRIC: As noted above in past medical history.

REVIEW OF SYSTEMS:
CONSTITUTIONAL: The patient has had no recent weight changes, fevers, night sweats or fatigue.
DERMATOLOGIC: She denies any lesions or rashes.
HEENT: Eyes: She has had no change in vision as mentioned in the history of present illness. ENT: No complaints other than the tooth injury she has at present.
CARDIOVASCULAR: She has had no chest pain, abnormal heart beats or shortness of breath.
RESPIRATORY: No wheezing or coughing.
GASTROINTESTINAL: She has had no nausea or vomiting and no abdominal pain or diarrhea.
GENITOURINARY: She has had no frequency, burning or flank pain and no vaginal symptoms.
MUSCULOSKELETAL: As noted in history of present illness.
ENDOCRINE: She has had no cold or heat intolerance or excessive thirst or urination.
HEMATOLOGIC: She has had no excessive bleeding or clotting.
NEUROLOGIC: As mentioned above, she has had no headaches, vision changes, dizziness, fainting or numbness, tingling or weakness from her accident.

ROS Examples 2

REVIEW OF SYSTEMS:  No nasal sinus congestion. No history of nasal trauma. No history of hypothyroidism. She is a prediabetic. She has no history of lung disease. She never smoked. No history of coronary artery disease, congestive heart failure or cardiac dysrhythmia. Gastrointestinal review of systems is negative. She is status post cholecystectomy. History of pancreatitis. She has a weight gain as noted above. Chronic fatigue and sleepiness and history of depression as noted above. Otherwise, review of systems is negative.

REVIEW OF SYSTEMS:  The patient has had intermittent fevers. Eye history is negative for photophobia or diplopia. She has had a bifrontal headache. She has not had any nuchal rigidity. She has no focal neurologic symptomatology. She has not had any sore throat or otalgia. She has not had any cough or productive sputum. She has had some mild lower abdominal cramping and flank pain. She had a recent diagnosis of UTI. Today, she developed vomiting. She has had no diarrhea. She has had myalgias. She has had no skin rashes. She has had no obtundation or neurologic changes.

REVIEW OF SYSTEMS:
CONSTITUTIONAL: The patient denies fevers, chills, sweats and body ache.
HEENT: Denies headache, blurry vision, eye pain, tinnitus, vertigo, gingival bleeding, sore throat, neck or thyroid masses.
RESPIRATORY: Denies cough, sputum, hemoptysis.
CARDIAC: Denies chest pain, pressure, palpitations, irregular heartbeats. Denies lower extremity edema.
GASTROINTESTINAL: Denies abdominal pain, changes in bowel habits or any bleeding on toilet paper.
GENITOURINARY: Denies dysuria, hematuria, nocturia or frequency. Occasional drips of urinary incontinence. She is a postmenopausal woman who has had no postmenopausal bleeding.
NEUROLOGIC: Denies headaches, dizziness, syncope.
MUSCULOSKELETAL: Positive for arthritis with joint stiffness in the morning. Denies muscle weakness. Limitation in range of motion.
VASCULAR: Denies claudication and cramping.
ENDOCRINOLOGY: Denies heat or cold intolerance. Positive for diabetes.
HEMATOLOGY: Denies easy bleeding or blood transfusion.
DERMATOLOGY: Denies changes in moles or pigmentation changes.
PSYCHIATRY: Denies depression, agitation or anxiety.

ROS Examples 3

REVIEW OF SYSTEMS:  The patient reports that she feels good. No recent changes. Denies recent fever. She did report that she has had recent vision difficulty and knows that she needs to see an ophthalmologist. Denies eye pain, inflammation, discharge, lesions. Reports no difficulty with hearing. No earaches or recent infections. Denies mouth pain. Denies bleeding of the gums. Denies sores and lesions in the mouth. Denies trouble swallowing or hoarseness. No neck pain. Denies limitation of motion. Denies lumps or swollen glands. Reports no changes in her breasts. Reports no nipple discharge, rash or swelling. No chest pain with breathing. Denies wheezing. Denies shortness of breath. Denies chest pain, cyanosis, fatigue, or trouble breathing on exertion. No history of heart murmur, hypertension, CAD, or anemia. Denies numbness or tingling. Denies swelling of the legs. The patient reports having a good appetite with no recent changes. Denies heartburn or indigestion or pain or nausea or vomiting. Denies difficulty with urination, urgency or frequency. Denies flank pain.

REVIEW OF SYSTEMS:  No fevers, chills, sweats, headaches, visual disturbances, ear, nose or throat complaints, cough, shortness of breath, sputum production, retrosternal chest pain, radiating pain, jaw pain, tooth pain, arm pain, hypertension, diabetes, dyslipidemia, heart or valve problems, heart attacks, strokes, seizures, thyroid illness, cancer. He had no periumbilical pain, abdominal pain, nausea, vomiting or diarrhea, constipation, hematochezia, melena, dark tarry stools, rashes, skin breakdown, numbness, tingling or paralysis. He denies any history of chronic kidney disease, peptic ulcer disease, gastritis, heartburn or reflux.

REVIEW OF SYSTEMS:
CONSTITUTIONAL: Denies fever or weight loss.
HEENT: Denies any visual changes or congestion. Reports intermittent sore throat over the last month. Denies any sinusitis.
CARDIOVASCULAR: Reports some chest discomfort associated with the chronic nausea and emesis that she has been having. Denies any palpitations, edema or syncope.
RESPIRATORY: Reports some intermittent shortness of breath relieved with her albuterol inhaler. Denies cough or wheezing.
GASTROINTESTINAL: Reports some abdominal cramping associated with her chronic emesis. Denies melena or hematemesis. Reports chronic daily nausea and emesis.
GENITOURINARY: Denies dysuria, urgency, discharge or bleeding currently.
MUSCULOSKELETAL: Denies any muscle or joint pain.
NEUROLOGIC: Denies headaches, dizziness, weakness, numbness or tingling in any of her extremities.
ENDOCRINE: Denies any polyuria, polydipsia or heat or cold intolerance.
PSYCHIATRIC: Reports having some stress at home and anxiety. Denies any depressive symptoms.
HEMATOLOGY: Denies any abnormal bleeding or bruising.

REVIEW OF SYSTEMS:
CONSTITUTIONAL: Denies fevers, weight change, headaches, visual changes, nausea or vomiting.
EYES: Denies cataract, glaucoma.
ENT: Denies nosebleeds, gum disease, has had his teeth extracted.
INTEGUMENTARY: Denies healing problems or rashes.
VASCULAR: Denies peripheral vascular disease, deep vein thrombosis, varicose veins.
NEUROLOGIC: Denies stroke, TIAs or seizures.
CARDIOVASCULAR: Has hypertension. Denies arrhythmia, myocardial infarction, congestive heart failure.
RESPIRATORY: Occasionally has wheezing, but denies the diagnosis of emphysema, bronchitis.
GASTROINTESTINAL: Denies peptic ulcer disease, liver disease, Hepatitis.
UROGENITAL: Denies any kidney disease, kidney failure.
MUSCULOSKELETAL: Denies gout or arthritis.
PSYCHIATRIC: Denies depression or anxiety.
ENDOCRINE: Denies diabetes or thyroid disease.
HEMATOLOGIC: Denies bleeding disorder, anemia.
IMMUNOLOGIC: Denies history of cancer, immunosuppression.

REVIEW OF SYSTEMS:
CONSTITUTIONAL: The patient notes that she has had a weight loss over the past one to two years of a significant amount.
HEENT: No history of trauma, vertigo or syncope. No history of photophobia, diplopia or color blindness. No history of nasal trauma, rhinitis or epistaxis. No history of tenderness or lesions of the oral cavity.
CARDIOVASCULAR: No history of palpitations, tachycardia, heart murmur, irregular rhythm, chest pain or discomfort.
RESPIRATORY: No history of asthma, shortness of breath, wheezing or pneumonia.
GASTROINTESTINAL: Please see the HPI.
GENITOURINARY: No history of dysuria, frequency or urgency.
MUSCULOSKELETAL: No history of weakness. No history of paresthesias, weakness, difficulty with coordination or balance.

REVIEW OF SYSTEMS:
CONSTITUTIONAL: Negative for fever, weight loss or night sweats.
HEAD AND NECK: Negative for visual changes, hearing changes, hoarseness, or sore throat. Negative for nasal problems. Positive for dry throat.
CARDIOVASCULAR: Positive for hypertension. Negative for coronary artery disease.
RESPIRATORY: Negative for shortness of breath, cough, asthma, or emphysema.
GASTROINTESTINAL: Negative for abdominal pain, nausea, vomiting, diarrhea, constipation, or hepatic disease.
GENITOURINARY: Positive for renal insufficiency, on dialysis.
HEMATOLOGIC: Denies anemia.
ALLERGIC/IMMUNOLOGIC: Positive for multiple myeloma.
INFECTIOUS: Denies infectious disease processes.
ENDOCRINOLOGY: Negative for diabetes mellitus. Negative for thyroid dysfunction.
MUSCULOSKELETAL: Positive for back pain with multiple compression fractures and sacral fracture noted as well worrisome for metastatic disease. The patient is receiving radiation therapy currently.
NEUROLOGIC: Denies seizures, strokes, or headaches.
PSYCHIATRIC: Denies anxiety or depression.
DERMATOLOGIC: Negative for skin condition.

REVIEW OF SYSTEMS:
CONSTITUTIONAL: No fever or weight loss. The patient has mild fatigue.
HEENT: Eyes: He uses glasses. No blurry vision or loss of vision. ENT: No loss of hearing, sinus drainage, difficulty swallowing.
CARDIOVASCULAR: Chest pain as noted in the history of present illness. No heart attack or palpitations.
RESPIRATORY: No shortness of breath, pneumonia, or pulmonary disease.
GASTROINTESTINAL: Reflux disease. No diarrhea or constipation.
GENITOURINARY: No dysuria, frequency, or kidney problems.
MUSCULOSKELETAL: No joint pain, arthritis, or muscle pain.
SKIN: No rashes or itching.
NEUROLOGIC: No stroke, seizure, or nerve damage.
PSYCHIATRIC: Depression. No mood swings or other mental disorder.
ENDOCRINE: Diabetes. No thyroid disorders.
HEMATOLOGIC: Anemia. No thrombocytopenia or bleeding disorders.

REVIEW OF SYSTEMS:
CONSTITUTIONAL: The patient states he is in fairly good health, with the exception of his vascular problems. No recent fever, chills, or severe weight changes. He states he has gained some weight recently.
INTEGUMENTARY: No complaints of problems with skin. No jaundice, rash, itching, lumps, or cellulitis. The only problem was the gangrene in his right leg.
HEENT: Ears: There is no hearing loss or tinnitus. Eyes: No visual changes or diplopia. Nose: No stuffiness, drainage, itching, or hay fever. No epistaxis. Throat and Mouth: No hoarseness, dysphagia, bleeding from his gums, leukoplakia, or sore throat.
NECK: No goiter, masses, nodules, or adenopathy.
CARDIOVASCULAR: He has hypertension. No edema.
RESPIRATORY: Positive for cough. He states he does cough up some sputum at times. It is clear yellow. No complaints of shortness of breath. No orthopnea or dyspnea.
GASTROINTESTINAL: No heartburn, dysphagia, decrease in appetite, indigestion, or hematemesis.
GENITOURINARY: He does not have any dysuria, polyuria, frequency, or incontinence.
PERIPHERAL VASCULAR: He does have a history of peripheral vascular disease. He has an amputation on the left and now on the right.