1. History
1.1. Social
1.1.1. Lives with husband daughter son in roxburry
1.1.1.1. Apartment
1.1.2. Lawyer
1.1.3. Feels safe
1.1.4. 3 Meals, some snacks, healthy diet
1.1.5. Alc: half glass beer once a week
1.1.6. Tob: half pack per day
1.1.6.1. Quit while pregnant
1.1.7. Sexually active
1.1.7.1. Only with husband
1.1.7.2. Does not use protection
1.1.7.3. Does not want to be pregnant again
1.1.7.4. No STIs in past
1.2. Past Medical
1.2.1. None
1.3. Surgical
1.3.1. C-section
1.4. Family Hx
1.4.1. Father: HTN
1.4.2. Mother: Diabetes
2. Present Illness
2.1. HPI
2.1.1. Never has happened before
2.1.2. Menstrual HX
2.1.2.1. First menses at 12
2.1.2.2. Very regular
2.1.2.3. LMP 3 months ago
2.1.2.4. Duration normally 3 days
2.1.2.5. No pain normally
2.1.2.6. Self described as Light
2.1.2.6.1. 3-4 pads on a normal day of menstruation
2.1.3. Gyn Hx
2.1.3.1. Had most recent child 10 months ago
2.1.3.1.1. Pregnancy was complicated
2.1.3.1.2. C-Section
2.1.3.1.3. 38 weeks
2.1.3.1.4. Menses resumed 2 months after birth
2.1.3.2. First pregnancy 4 years ago
2.1.3.2.1. Vaginal birth of healthy child
2.1.3.2.2. 37 weeks
2.1.3.3. 2 total pregnancies
2.1.3.4. No hormonal birth control currently
2.1.3.4.1. Has tried pill and shot in the past
2.1.4. No pregnancy test yet taken
2.1.5. Feels "shaky"
2.1.5.1. Vibrations in body
2.1.5.2. Once a day
2.1.5.3. Has been happening for few months
2.1.5.4. Feels restless
2.1.5.5. Headache when this happens
2.1.6. Recent weight loss
2.1.6.1. 15 lbs past 6 months
2.1.6.2. Training for boston marathon
2.1.7. Sweating
2.1.7.1. started 6 months ago
2.2. ROS
2.2.1. No Pain
2.2.2. No change in mood
2.2.3. No changes in apatite
2.2.4. -Chills, nausea, vomiting, dysuria, bowel irregularities,
3. Physical Exam / Data
3.1. Physical Exam
3.1.1. Pulse:120bpm
3.1.2. -exotpthalmos
3.1.3. Thyroid enlarged, bruit
3.1.4. II/VI systolic murmer UL sternal border
3.1.5. Tremor
3.1.6. Reflexes 3+
3.1.7. Stare and lid lag
3.1.8. warm moist skin
3.2. Labs
3.3. Imaging
4. 2ry Amenorrhea
4.1. Most likely
4.1.1. HyperThyroid
4.1.1.1. Graves