Reference no: EM133689114

Question

Linda has a sz disorder, stable on Keppra with no seizures. She also has what she describes as chronic pain in her hands and L knee. She doesn't remember being diagnosed with RA or OA and has taken acetaminophen for the pain. She does have stiffness in mornings for about 30-minutes as well as Bouchard's nodes. She ambulates without assistance. She has been told she is hypertensive in the past but never treated. The last two times we saw her, her BP was 140s/90s. Concurrently, she also has had worsening menorrhagia for the last 4-6 months. It is cyclic without spotting between cycles, but she saturates pads every 1-2 hours while menstruating and cycles last 4 days. She has not had any imaging. She has been told she was anemic in the past and a thyroid d/o but doesn't have specifics. She did say she had a normal Pap smear (HPV unknown) two years ago in San Jose. She is sexually active with her husband and not sure whether she wants to contracept. She is a heavy tobacco user, uses methamphetamine - her husband recently stopped using - and it is a source of tension between them. He wants her.