The patient's medical profile has been updated: active problems, medical history, current medications, vital signs, lifestyle habits, and recent clinical events have been changed. New laboratory test results and changes in the treatment plan have been added. All tests were successful.

clinical_background.json

@@ -1,73 +1,77 @@
 {
     "patient_summary": {
         "active_problems": [
-            "Type 2 diabetes mellitus (09/15/2023)",
-            "Essential hypertension (09/15/2023)", 
-            "Hyperlipidemia (11/22/2023)",
-            "Obesity (BMI 31.2) (01/15/2025)",
-            "Prediabetic neuropathy - mild (03/10/2024)"
+            "Atrial fibrillation s/p ablation (08/15/2024)",
+            "Deep vein thrombosis right leg (06/20/2025)", 
+            "Obesity (BMI 36.7) (07/01/2025)",
+            "Hypertension (controlled on medication)",
+            "Sedentary lifestyle syndrome",
+            "Computer vision syndrome",
+            "Chronic venous insufficiency right leg"
         ],
         "past_medical_history": [
-            "Type 2 diabetes mellitus diagnosed 2023",
-            "Essential hypertension diagnosed 2023",
-            "Hyperlipidemia",
-            "Family history of cardiovascular disease",
-            "Former smoker - quit 2022"
+            "Atrial fibrillation diagnosed 2023, ablation August 2024",
+            "Deep vein thrombosis right leg June 2025",
+            "Essential hypertension diagnosed 2022",
+            "Obesity - progressive weight gain over 10 years",
+            "Family history of stroke and hypertension"
         ],
         "current_medications": [
-            "Metformin - 1000 MG - Tablet - twice daily with meals",
-            "Lisinopril - 10 MG - Tablet - once daily in morning",
-            "Atorvastatin - 20 MG - Tablet - once daily at bedtime",
-            "Aspirin - 81 MG - Tablet - once daily",
-            "Multivitamin - once daily"
+            "Xarelto (Rivaroxaban) - 20 MG - once daily with evening meal",
+            "Atenolol - 50 MG - once daily in morning", 
+            "Metoprolol - 50 MG - twice daily",
+            "Lisinopril (Lyxarit) - 10 MG - once daily",
+            "Compression stockings - daily use for right leg"
         ],
         "allergies": "No known drug allergies"
     },
     "vital_signs_and_measurements": [
-        "Blood Pressure: 145/92 (02/01/2025)",
-        "Blood Pressure: 142/89 (01/15/2025)",
-        "Height: 1.78 m (5'10\")",
-        "Weight: 99.1 kg (218 lb) (02/01/2025)",
-        "BMI: 31.2 kg/m² (02/01/2025)",
-        "Temperature: 98.2°F (02/01/2025)",
-        "Heart Rate: 78 bpm (02/01/2025)",
-        "Respiratory Rate: 16 (02/01/2025)"
+        "Blood Pressure: 128/82 (07/01/2025) - well controlled",
+        "Heart Rate: 65 bpm regular (07/01/2025)",
+        "Height: 1.82 m (6'0\")",
+        "Weight: 120.0 kg (264 lb) (07/01/2025)",
+        "BMI: 36.7 kg/m² (Class II Obesity)",
+        "Temperature: 98.6°F (07/01/2025)",
+        "Oxygen Saturation: 98% (07/01/2025)"
     ],
     "laboratory_results": [
-        "HbA1c: 8.2% (01/20/2025) - Target <7%",
-        "Fasting Glucose: 165 mg/dL (01/20/2025) - Target <130 mg/dL",
-        "Total Cholesterol: 195 mg/dL (01/20/2025)",
-        "LDL: 125 mg/dL (01/20/2025) - Target <100 mg/dL",
-        "HDL: 38 mg/dL (01/20/2025) - Target >40 mg/dL",
-        "Creatinine: 1.1 mg/dL (01/20/2025) - Normal",
-        "eGFR: 75 mL/min/1.73m² (01/20/2025) - Mild decrease"
+        "INR: 2.1 (07/15/2025) - therapeutic on Xarelto",
+        "D-dimer: 850 ng/mL (06/25/2025) - elevated, improving",
+        "Total Cholesterol: 220 mg/dL (07/01/2025)",
+        "LDL: 145 mg/dL (07/01/2025)",
+        "HDL: 35 mg/dL (07/01/2025) - low",
+        "Creatinine: 0.9 mg/dL (07/01/2025) - normal",
+        "BNP: 95 pg/mL (07/01/2025) - normal"
     ],
     "imaging_studies_and_diagnostic_procedures": [
-        "ECG: Normal sinus rhythm, no acute changes (01/15/2025)",
-        "Diabetic eye exam: Mild background retinopathy, no referral needed (12/10/2024)",
-        "Diabetic foot exam: No ulcers, sensation intact, good circulation (01/15/2025)"
+        "Doppler ultrasound right leg: Acute DVT in popliteal and posterior tibial veins (06/20/2025)",
+        "Echocardiogram: EF 55%, mild LA enlargement, no structural abnormalities (05/15/2025)", 
+        "ECG: Normal sinus rhythm, no acute changes post-ablation (07/01/2025)",
+        "Holter monitor: Rare isolated PVCs, no atrial arrhythmias (06/01/2025)"
     ],
-    "assessment_and_plan": "52-year-old male with Type 2 diabetes and hypertension, both suboptimally controlled. Recent HbA1c of 8.2% indicates need for improved glucose management. Blood pressure averaging 145/92 despite medication. Patient motivated for lifestyle changes. Plan: Continue current medications, intensive lifestyle counseling for diet and exercise, follow-up in 3 months with repeat labs. Patient educated on glucose monitoring and lifestyle modifications.",
+    "assessment_and_plan": "42-year-old male computer science professor with recent DVT on anticoagulation and history of atrial fibrillation s/p successful ablation. Currently stable on medications. DVT improving with anticoagulation. Major lifestyle factors: severe obesity (BMI 36.7) and sedentary lifestyle contributing to thrombotic risk. Cleared for gentle, progressive exercise program with cardiac monitoring. Weight loss critical for reducing future cardiovascular events.",
     "critical_alerts": [
-        "HbA1c above target (8.2%) - requires lifestyle intervention",
-        "Blood pressure above goal - monitor closely",
-        "Weight management critical for diabetes control"
+        "On anticoagulation therapy - bleeding risk with trauma/falls",
+        "Recent DVT - requires graduated compression and monitored activity", 
+        "Post-ablation - cardiac monitoring recommended during exercise initiation",
+        "Severe obesity - exercise prescription must be gradual and supervised"
     ],
     "social_history": {
-        "smoking_status": "Former smoker, quit January 2022",
-        "alcohol_use": "Social drinking, 2-3 beers per week",
+        "smoking_status": "Never smoker",
+        "alcohol_use": "Occasional wine with dinner, 1-2 glasses per week",
         "caffeine_use": {
-            "coffee": "3-4 cups per day",
-            "soda": "1-2 diet sodas daily"
+            "coffee": "4-5 cups per day",
+            "energy_drinks": "None"
         },
-        "occupation": "Office manager, sedentary work",
-        "exercise_history": "Minimal - walks occasionally on weekends",
-        "family_support": "Married, wife supportive of health changes"
+        "occupation": "University Professor, Computer Science - 8-12 hours daily at computer",
+        "exercise_history": "Former competitive swimmer in university (1990-1994), now sedentary for 25+ years",
+        "family_support": "Lives alone, supportive colleagues and students"
     },
     "recent_clinical_events_and_encounters": [
-        "2025-02-01: Routine diabetes follow-up. HbA1c reviewed, medication compliance good. Discussed lifestyle modifications.",
-        "2025-01-15: Annual physical exam. Blood pressure elevated, weight increased 5 lbs from last visit.",
-        "2024-12-10: Diabetic eye exam - mild background retinopathy noted, annual follow-up recommended.",
-        "2024-11-20: Medication review visit - patient reports good tolerance of current regimen."
+        "2025-07-01: Cardiology follow-up - stable rhythm, good BP control, weight management discussed.",
+        "2025-06-25: DVT follow-up - improving with anticoagulation, compression therapy reinforced.",
+        "2025-06-20: Emergency visit - diagnosed with acute DVT right leg, started on Xarelto.",
+        "2025-05-15: Post-ablation follow-up - excellent results, rhythm stable, cleared for gradual activity increase.",
+        "2024-08-15: Successful atrial fibrillation ablation procedure."
     ]
 }