A 46-year-old, 230lb woman with a family history of breast cancer. She is up to date on yearly mammograms. She has a history of HTN. She complains of hot flushing, night sweats, and genitourinary symptoms. She had felt well until 1 month ago and she presented to her gynecologist for her annual gyn examination and to discuss her symptoms. She has a history of ASCUS about 5 years ago on her pap, other than that, Pap smears have been normal. Home medications are Norvasc 10mg qd and HCTZ 25mg qd. Her BP today is 150/90. She has regular monthly menstrual cycles. Her LMP was 1 month ago. What is wrong with this patient?

What is wrong with this patient?

First, the patient seems to be overweight or obese based on her weight even though the correct calculation of BMI is undetermined because the height was not specified. The patient's hot flashes, night sweats, and genitourinary symptoms could be symptoms of menopause experienced by women in their 40s to 50s brought about by the changing hormone levels. The patient's Pap Smear 5 years ago revealed Atypical Squamous Cells of Undetermined Significance or ASCUS. This means that it showed slightly abnormal squamous cells but it doesn't mean that it is precancerous so the patient should not be alarmed. It could be caused by an infection or inflammation. Also, you do not need to worry seeing that the following Pap smears have been normal. As for the patient's Hypertension, her blood pressure is a bit high 150/90 seeing that she is already taking her anti-hypertensive medications so I would suggest she go for a check-up and ask the doctor so the doctor can either titrate her meds to a higher dose or give her another medication.