I have recurrent H. Pylori infection. M.C. a 46-year-old hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has pmhx of dyspepsia, GERD. She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods. Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms. Diabetes Mellitus, type 2 She receives an annual flu shot. Last flu shot was this year gh school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago. Both parents are alive. Father has history of DM type 2, Tinea Pedis. mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis. Constitutional: Negative for fever. Negative for chills. Respiratory: No Shortness of breath. No Orthopnea Cardiovascular: No edema. No palpitation
s. Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain. Skin: No lesions. No rash. No itching. Psychiatric: No anxiety. No depression. Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored : Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness. : Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. : Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress. : Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema. : No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. : No CVA tenderness bilaterally. GU exam deferred. : Slow gait but steady. No Kyphosis. Dry. Intact. : Normal affect. Cooperative. :: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal No new labs are needed. : may refer based on effect of medication therapy given for 2 weeks. : return to office in 8 weeks to reevaluate her symptoms.