60  Years old female patient 

known to have   paplitarey  thyroid   cancer     s/p  thyroidectomy 
adrenal adenoma 
pitutary adenoma 
ckd 
right atrophied kidney 
left kidney   showed   cyst 


impression 
mutipglanuler    endoscinopathy 
hip replacemtn 
crohns  disease 

medications

plan
add  carvidelol   6.25  1x2 
lasix   40 mg once 
zainnat  500 mg 1x2 


rtc after   2 weeks   with new  labs  to   be done at    alia hospital 
she is  welling to do echo  at  dr  asraf  clinic 